Develop the provider network through contract negotiations, relationship development, industry analysis and servicing.
Analyze, review, and project financial impacts of network contract arrangements.
Implement reimbursement strategies designed to control healthcare costs.
Blue Cross of Idaho is an Idaho-based health insurance company that has been around since 1945. As a not-for-profit, they are driven to help connect Idahoans to quality and affordable healthcare while building strong networks and services with the help of customer-centric professionals.
Lead the development and execution of Clover’s provider network strategy in New Jersey.
Establish and execute on an annual contracting roadmap aligned with affordability, access, and quality goals.
Lead a team to deliver high-quality and data-driven contracting operations.
Clover Health reinvents health insurance by combining data and human empathy to keep members healthier. They have created custom software and analytics to empower their clinical staff to intervene and provide personalized care.
Lead the direct negotiation of CareCentrix provider contracts.
Manage the full lifecycle of contract negotiations.
Collaborate with stakeholders to ensure contract terms align with requirements.
CareCentrix manages the provider network. They support contracting activities and oversee network providers across multiple payers; they have an award winning culture and value their employees.
Serves as principal lead on a defined number of providers for negotiation, strategy, and market intelligence.
Assist in the establishment of contract-related criteria and contracting guidelines to optimize financial performance and minimize Plan risk.
Responsible for understanding provider partners’ service needs and incorporating contract solutions to support providers and Capital Blue Cross in reaching shared goals.
Capital Blue Cross aims to go the extra mile for their team and community. Employees consistently vote them one of the “Best Places to Work in PA” due to their supportive colleagues and focus on professional and personal growth.
Maintain and deepen senior-level relationships across national and regional payers.
Wheel is evolving the traditional care ecosystem by equipping the nation's most innovative companies with a premier platform to deliver high-quality virtual care at scale. They offer proven strategies and cutting-edge technologies to foster consumer engagement, build brand loyalty, and maximize return on investment.
Lead the development, optimization, and performance of Clover’s dental provider network.
Build Clover’s dental network strategy from the ground up across markets.
Build, scale, and lead a high-impact dental network team spanning contracting, analytics, and provider relationship management.
Clover Health is committed to providing high-quality, affordable, and easy-to-understand healthcare plans for America’s seniors. The company prioritizes preventive care while leveraging data and technology; they are passionate and mission-driven individuals with diverse areas of expertise.
Partner with payer clients as a trusted clinical advisor to design drug management strategies.
Assess and benchmark PBM and other industry vendor clinical programs.
Leverage medical and pharmacy data to assess program performance.
PSG (Pharmaceutical Strategies Group), an EPIC owned company, provides consultative guidance to payer clients in the drug management market. They have over 3,000 employees nationwide and foster a 50/50 culture between producers and the rest of the business, supporting collaboration and teamwork.
Own and actively drive a defined pipeline of payer opportunities.
Initiate, build, and expand relationships with assigned payer accounts.
Lead payer meetings from initial outreach through follow-up execution.
GRAIL is working to change the trajectory of cancer mortality and bring stakeholders together to adopt innovative, safe, and effective technologies that can transform cancer care. We have locations in the bay area of California, with locations in Washington, D.C., North Carolina, and the United Kingdom.
Create innovative clinical programs, products, and services aimed at optimizing specialty and non-specialty drug management, support payer clients with their PBM and drug coverage decisions
Act as a detail-oriented advisor, using data-driven insights to evaluate pharmacy programs, identify trend drivers, outlier high-cost claims and drive improvements.
Monitor emerging market trends and drug pipelines to anticipate client impact and develop proactive solutions.
Pharmaceutical Strategies Group (PSG), an EPIC owned company, provides an integrated data and analytics platform that transforms member data into actionable intelligence, which drives improved management of drug spend and trend across both pharmacy and medical benefits. EPIC has over 60 offices and 3,000 employees nationwide.
Partner with RCM leadership to monitor performance trends and identify revenue cycle opportunities.
Support payer contracting activities, including onboarding clinical network agreements.
Act as program manager for strategic payer partnership initiatives and drive implementation.
Headspace provides access to lifelong mental health support. They combine content, clinical care, and technology to help millions of members around the world get support. Their culture is collaborative, inclusive, and grounded in their values.
Own end-to-end contract lifecycle for extensive contract portfolio.
Partner directly with practices to ensure successful contract onboarding and ongoing compliance.
Act as the SME of the Explorer market with all relevant groups such as Payer Networks, SPP, Withdrawal, Legal, and Growth teams.
Aledade, a public benefit corporation, empowers independent primary care. Founded in 2014, they've become the largest network of independent primary care in the country, helping practices deliver better care and thrive in value-based care with a collaborative, inclusive, and remote-first culture.
Primary owner of imaging center relationships after contract signing.
Lead onboarding, drive engagement, and manage Single Case Agreements (SCAs).
Resolve complex issues across scheduling, billing, and referral workflows.
Scan.com is a digital health scale-up that makes diagnostics accessible, fast, and transparent. Their technology speeds up diagnoses for timely treatments, improving healthcare outcomes for hundreds of patients each day. The company has raised over $70m in VC funding, reached profitability, and has a growth trajectory of over 100% YoY.
Oversees the management of contractual documents that establish business relationships with vendors, customers and/or partners.
Advises management of contractual rights and obligations and provides interpretation of terms and conditions.
Manages team responsible for data entry, configuration within systems and maintenance of all changes in terms and conditions of payor contracts.
Hanger, Inc. is the world's premier provider of orthotic and prosthetic (O&P) services and products, offering the most advanced O&P solutions, clinically differentiated programs and unsurpassed customer service. Hanger's vision is to lead the orthotic and prosthetic markets by providing superior patient care, outcomes, services and value.
Own and lead the end-to-end provider strategy for the Northeast market.
Act as the primary voice of the market and provider network, translating on-the-ground insights.
Define, track, and continuously evolve key operational KPIs.
RightMove is redefining how value-based musculoskeletal (MSK) care is delivered in partnership with the Hospital for Special Surgery (HSS). They partner with PCPs, Orthopedic specialists, and health plans to deliver high-value, patient-centered MSK care and are a startup with enterprise-grade rigor.
Work closely with stakeholders to deliver Site Contracts in the shortest possible time and align with study timelines.
Support contract negotiations and deal with key clients; participate in strategic initiatives.
Manage a team of contract and budget associates, allocate resources, and report on contract metrics.
Precision for Medicine is dedicated to streamlining the clinical trial process through science and technology. While specific employee numbers aren't provided, they foster a culture of innovation and collaboration within the clinical research field.
Serve as a primary point of contact for contract-related inquiries.
1Password is building the foundation for a safe, productive digital future. They innovated the market-leading enterprise password manager and pioneered Extended Access Management, a new cybersecurity category built for the way people and AI agents work today.
Serves as procurement resource for assigned categories and/or departments through collaboration with business unit leaders.
Leads the negotiation of the financials, contract length, and deliverable / product / service terms of supplier contracts.
Develops and analyzes key reporting metrics designed to track overall efficiency of the process and internal spend data for assigned categories.
EMC strives to be caring leaders, close partners, and responsive experts, always supporting each other to do their best work. They have more than 105 years of financial strength and stability and a corporate culture that engages and empowers team members.