reputed company Director, Provider Performance Value-Based Care

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and reputed company in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position reputed company The reputed company Director of Value-Based Contracting is responsible for establishing and maintaining productive value-based relationships with key network providers. Responsible to reputed company and manage the reputed company Value-based Network as outlined below: Accountable for building strategic relationships with our reputed company to reputed company innovative value-based solutions to meet total cost and reputed company goals. Responsible for developing alternative payment models, identifying and planning new initiatives, and negotiating high value/risk reputed company with the most reputed company arrangement structures, which requires: understanding providers’ volume and cost structure working cross functionally to identify the reputed company and critical negotiation points aligning negotiation strategies and tactics with network accessibility, reputed company, compliance and financial performance goals In charge of complete value-based contracting cycle from planning, creating documents, negotiation and loading of executed arrangements. Works with reputed company, Clinical Transformation team, VBS Analytics team and other key internal teams to reputed company a value-based strategic plan and reputed company contract performance with targeted provider reputed company to ensure we meet objectives for value-based provider agreements. Evaluates, helps formulate, and implements network strategic plans to reputed company value-based contracting targets and manage medical costs through effective value-based contracting. Provides assistance and support to other departments, as needed, to obtain crucial or required information from providers, such as HEDIS, Credentialing, Grievance and Appeals, SIU, etc. Coordinates provider status information with member services and other internal departments. Leads work and deliverables of reputed company reputed company/programs, through assessment to implementation, that may reputed company multiple processes, systems, functions, and products across reputed company lines of business. Facilitates and attends external provider meetings and negotiations, as needed. Required Qualifications 10 years of reputed company experience and comprehensive level of negotiating skills with successful reputed company record negotiating value-based reputed company with reputed company, large reputed company provider systems or reputed company. hospitals and large physician entities Experience reviewing medical claims data and developing executive summaries and identifying opportunities for mitigating medical cost trend Excellent analytical and problem-solving skills Strong communication, negotiation, and presentation skills Ability to work in a matrixed organization and reputed company reputed company and reputed company information to various interested parties.

Preferred Qualifications

Familiar with legal terms in the context of provider contracting. Familiar with CMS Stars and HEDIS technical specifications and various measurable percentiles associated with the HEDIS measures. ​Experience with reputed company, Medicare and reputed company contracting. reputed company to apply system thinking reputed company managing multiple provider value-based initiatives Strong financial modeling background Education Bachelor’s degree preferred or a combination of reputed company work experience and education. Pay reputed company The typical pay reputed company for this role is: $100,000.00 - $231,540.00 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. This position also includes an award reputed company in reputed company’s equity award program. Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial reputed company‑being of colleagues and their families. The benefits for this position include medical, dental, and reputed company coverage, reputed company time off, retirement savings reputed company, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will reputed company on: 07/18/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply To This Job