Negotiate MA & Medicaid value-based care contracts with prospective payer partners.
Collaborate with Senior Leadership to qualify and source market growth and expansion for multi-year risk arrangements.
Build and manage relationships with payers and other key stakeholders to resolve issues and optimize performance.
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, operating with a collaborative, inclusive, and remote-first culture.
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.
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.
McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. They are known for delivering insights, products, and services that make quality care more accessible and affordable and foster a culture where employees can grow and make an impact.
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 strategic leadership for a focused portfolio of health plan accounts, driving retention and growth.
Serve as primary executive advisor, cultivating trusted C-suite relationships and leading high-impact negotiations.
Leverage financial modeling and analytics to assess profitability and guide account planning for client and organizational value.
CareCentrix provides healthcare services, focusing on post-acute care management and home-based solutions. They emphasize a values-driven culture centered on caring, doing the right thing, striving for excellence, thinking big, and taking work seriously.
Hire, coach, develop and retain a high-performing team of primary care sales representatives utilizing available tools.
Deliver sales performance and relevant Brand Key Performance Indicators (KPIs) in order to meet or exceed district sales plan within expense budgets.
Oversee the daily in-field activity and day-to-day management of assigned team members to achieve results within specific district/geographical assignment.
Shionogi Inc. is a pharmaceutical company. They are committed to undertaking affirmative action; the company focuses on non-discriminatory employment practices.
Manage a team of claims professionals including Claims Program Management, Training & Development, and Stop Loss/Travel operations.
Implement and manage a long-term strategy aligned with the division’s objectives.
Establish and monitor benchmarks and metrics for team performance.
Crum & Forster’s Accident & Health division (A&H) offers specialty insurance and reinsurance products nationwide. They focus on product development, creative distribution, and client service.
Management and oversight of a quality team conducting quality assurance activities.
Responsible for the successful execution of the Quality Improvement Program in accordance with CMS requirements.
Plans, organizes, and directs activities of Clinical Quality, including planning, training, and staff development.
HealthEdge is committed to workforce diversity and actively encourages all qualified persons to seek employment. They provide effective and efficient solutions to complex business problems.
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.
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.