Website Express Scripts
The Medicare Market Vice President, Network Management will lead the development and execution of our Statewide Florida Medicare Advantage network provider strategy, with a focus on the development of relationships, contracting and engagement with our network partners. Success in this role will largely be determined by the ability to develop and communicate the vision for a truly innovative and outcomes-based network growth strategy, considering ever evolving competitive marketplace and provider landscape.
- Manages complex contracting with primary care providers, specialists, hospitals, and ancillaries (e.g., Hospital systems and large physician groups).
- Implement Florida specific Medicare Advantage provider network strategies, including contracting relationships and innovative value based incentive programs to enable high performing networks measured through quality and affordability, and in pursuit of becoming the undisputed partner of choice.
- Develop the Central Florida provider network and collaborate on statewide provider network growth initiatives, to achieve quality, growth and financial performance targets across HMO and PPO (individual and group) offerings.
- Works to meet unit cost targets, while preserving an adequate network, to achieve and maintain Cigna’s competitive position.
- Manages strategic positioning for provider contracting, develops networks and identifies opportunities for greater value-orientation and risk arrangements.
- Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
- Contributes to the development of alternative network initiatives. Supports and provides direction to develop network analytics required for the network solution.
- Initiates and maintains effective channels of communication with matrix partners including but not limited to, National and local market network Operations, Claims
- Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service.
- Leader from a large, complex managed care organization or provider system with an innovative risk oriented capability with a proven ability to lead a portfolio of markets or business units that is both analytical and customer oriented from a strategic and operational perspective.
- Effective communicator to executive level staff and external audiences balanced with strong interpersonal skills.
- Creative problem solving and analytical thinking with a perspective of our provider partners and customers.
- Strong influencing and negotiation skills, distribution management, contracting and network savvy, business owner mindset and ability to successfully lead in an ambiguous and changing market with the evolution of healthcare reform, collaborative care and delivery system alliance development and expansion, and the need for governmental influence and savvy.
- Proven track record of exceeding goals and a bottom-line orientation; evidence of the ability to consistently make good decisions through a combination of analysis, wisdom, experience, and judgment; high level of business acumen, including the ability to balance the delivery of programs against the realities of a budget; allocates resources and manages operating expenses to maximize P&L while managing risk.
- Proven success in developing strategic and operational platforms and leading / mentoring a high-performance management team.
- Demonstrated results in being able to think strategically, anticipate future consequences and trends, and incorporate them into both a short-term and long-term organizational plan.
Qualification & Experience:
- Experience building strong and authentic relationships with large health systems and provider groups.
- Degree in health administration, business administration, or another related field (MBA desirable) and/or 15 or more years in a progressively responsible leadership role focused on managed Medicare and provider engagement.
Company: Express Scripts
Vacancy Type: Full Time
Job Location: Daytona BeachFL, US
Application Deadline: N/A