Oversee the Commercial segment within the Strategic Payer Partnerships team ensuring performance goals and objectives are met.
Collaborate with Executive Leadership to shape Aledade's strategy for value-based contracting on behalf of independent primary care practices.
Lead, direct, and evaluate a team of senior leaders ranging from Manager to Sr. Director.
Aledade empowers independent primary care practices to deliver better care to their patients and thrive in value-based care. Founded in 2014, they are the largest network of independent primary care in the country with a collaborative, inclusive, and remote-first culture.
Lead and manage a team of Regional Directors, providing coaching and performance feedback.
Oversee the delivery of consulting services to specialty provider practices.
Develop and implement strategies to support the needs of specialty customers.
The company is looking for a Lead Director, Managed Care. They value creating an inclusive culture by empowering employees to bring their unique and diverse selves to work.
Develop and execute commercial reimbursement strategies aligned with company objectives and growth plans.
Lead engagement with national, regional, and local commercial health plans.
Provide direct people management and leadership for the Market Access Manager team.
Calyxo, Inc. is a medical device company that addresses the need for improved kidney stone treatment. They're a dynamic team with experienced leaders and investors who aim to commercialize devices to meet unmet needs within urology.
Help network development and contracting goals within designated geographies.
Develop and refine local contracting strategies to drive provider participation in Medicare Advantage, Direct Contracting and other value-based initiatives.
Address and resolve any concerns raised by providers and effectively communicate those solutions to internal stakeholders.
Clover Health is a Medicare Advantage and Prescription Drug plan changing how healthcare is delivered by combining data with human empathy to keep members healthier. They are passionate and mission-driven individuals, working together to solve the most complicated problem in the world: healthcare.
You will own payer contracting strategy, aligning business interests with legal terms and regulations.
You will build for scale and implement systems to land high-value payer contracts efficiently.
You will review and negotiate the terms of Headway’s health plan agreements.
Headway is building a new mental healthcare system everyone can access by solving the biggest barrier to care: insurance. It is a Series D company with $325M+ in funding with over 75,000 providers across all 50 states that run their practice on their software, serving over 1 million patients.
Communicating with providers regarding claims, service issues and general network provider complaints.
Developing an adequate provider network in assigned geographical areas (currently Texas metroplex areas).
Building and maintaining relationships with contracted providers, including inquiries related to contract status, roster corrections and information accuracy.
Evry Health, a Globe Life company, aims to bring humanity to health insurance. They are a high-technology health plan expanding benefits and access, and feature a personalized, human approach. Globe Life has 16.8 million policies in force, with more than 3,000 corporate employees and 15,000 agents.
Own the profitable renewal of assigned clients including strategy development, internal resource coordination, and external negotiation.
Build and maintain trusted peer-level relationships with national and regional benefits consultants and brokers.
Directly supervise SAEs and AEs; set clear expectations, provide regular coaching, and conduct performance evaluations.
VytlOne is an independent, fully integrated total pharmacy solutions partner. They offer hospitals, health systems, health centers, and employer partners a smarter way to unlock revenue, growth, and better outcomes. They have over 1,600 passionate professionals.
Oversee the enterprise sales cycle, pipeline and progress for the Clinical Operations, Risk Adjustment and Quality Divisions.
Lead go-to-market strategy and sales execution for Clinical Operations solutions, including Utilization Management, Care Management, and Appeals & Grievances, articulating value to health plan operational and clinical buyers.
Drive pipeline development and revenue growth for Risk Adjustment offerings (both retrospective and prospective SaaS/BPaaS models) across Medicare Advantage, ACA, and Managed Medicaid markets.
HealthEdge is dedicated to meeting the business’s annual and long-term financial objectives, ensuring ongoing customer satisfaction, and increasing HealthEdge brand awareness and market visibility. They are committed to building an environment and culture that supports the diverse representation of our teams.