Director, Provider Contracting Medicare

Your Role

The Director, Provider Contracting for Medicare will report to the VP Provider Contracting. In this role, you will be responsible for leading and defining an optimal network strategy by region in collaboration with Medicare Advantage (MA) leadership and leading network design and contracting efforts for MA HMO and PPO plans. Additionally, this role will be responsible in leading and participating in strategic initiatives including, but not limited to, network expansion. We are looking for a strong leader with deep knowledge of Medicare to drive MA network strategy, optimize costs, and support quality performance. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building, and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience

• Requires a college degree or equivalent experience
• Requires 10 years provider contracting experience at a senior negotiator level
• Requires 6 years of people management experience at a health plan or in a provider organization
• Knowledge of health plan operations, products, and competitor marketplace
• Experience and working knowledge of the California Medicare Marketplace
• Excellent interpersonal and communication skills, including effective delivery of executive level reports and in-person presentations
• Comfortable working with Microsoft Office/Teams/Salesforce. Appetite to explore newer artificial intelligence sales tools