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Indiana University Health

Director-Network Management and Strategy

IU Health Plans
Date Posted
18 December, 2020
Schedule & Shift
Full Time
Day
Requisition Number
274657
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Director-Network Management and Strategy

Job Description

Overview

Partners with IU Health Plans product teams and IU Health System to determine the provider network strategy. Directs and oversees contracting efforts in negotiating provider, ancillary and durable medical equipment contracts for IU Health Plans, provider relation efforts for all IU Health employed and non-IU Health providers in the IU Health Plans network as well as provider data management efforts to maintain accurate provider demographics. Assesses and adjusts the provider network portfolio to meet all regulatory and business adequacy requirements. Assesses and is accountable for ensuring competitive reimbursement rates in the marketplace. Responsible for monitoring, assessing and ensuring appropriate capabilities to stay ahead of shifts in contracting strategies in the marketplace such as value based contracting arrangements.

 Requires 7-10 years of experience with managed care contract negotiations involving physicians, ancillaries and hospital systems.
• Requires strong working knowledge of provider revenue, reimbursement, and Medical Expense Ratio. Bachelors degree required; Masters preferred (MHA, MSPH)JD CPA

 

We are an equal opportunity employer and value diversity and inclusion at IU Health. IU Health does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.

Qualifications for the Director-Network Management and Strategy Role

Overview

Partners with IU Health Plans product teams and IU Health System to determine the provider network strategy. Directs and oversees contracting efforts in negotiating provider, ancillary and durable medical equipment contracts for IU Health Plans, provider relation efforts for all IU Health employed and non-IU Health providers in the IU Health Plans network as well as provider data management efforts to maintain accurate provider demographics. Assesses and adjusts the provider network portfolio to meet all regulatory and business adequacy requirements. Assesses and is accountable for ensuring competitive reimbursement rates in the marketplace. Responsible for monitoring, assessing and ensuring appropriate capabilities to stay ahead of shifts in contracting strategies in the marketplace such as value based contracting arrangements.

  • qualifications__list
     Requires 7-10 years of experience with managed care contract negotiations involving physicians, ancillaries and hospital systems.
  •  Requires strong working knowledge of provider revenue, reimbursement, and Medical Expense Ratio. Bachelors degree required; Masters preferred (MHA, MSPH)JD CPA
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Indiana University Health is Indiana’s most comprehensive health system, with 16 hospitals and more than 34,000 team members serving Hoosiers across the state. Our partnership with the Indiana University School of Medicine gives our team members access to the very latest science and the very best training, advancing care for all. We’re looking for team members who share the things that matter most to us. People who are inspired by challenging and meaningful work for the good of every patient. People who are compassionate and serve with a purpose. People who aspire to excellence every day. People who are always ready to apply themselves.

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