VP - Provider Contracting and Network Operations, Albuquerque, NM

Apply Here

The VP of Provider Contracting and Network Operations has accountability for all aspects of provider contracting, network operations, and provider services. The VP develops strategic partnerships with key providers, providing best in class engagement and driving optimal performance in quality, financials, risk adjustment, utilization management, financial performance, and membership retention and growth. You lead provider network and provider contracting strategies to ensure a robust provider network that meets the needs of our membership, in addition to regulatory requirements. This leader serves as a subject-matter-expert on value-based contracting, standard and advanced provider payment models, and emerging provider payment models and is accountable for provider contract performance and financial outcomes.

Qualifications

• Bachelors degree or equivalent experience in Business Administration, Healthcare Administration or related field.
• Masters Degree Preferred.
• 15+ years of combined experience in managed care, provider contracting, provider network operations and management, and health plan operations experience.
• Knowledge of New Mexico market preferred.
• Must reside in New Mexico.

Apply Here