Position Summary:

The VP of Provider Network is responsible for the overall Provider Network Strategy to include: relationship management with key systems and providers, payment strategies to drive lower costs and take complexity out of the system and maintain a strong service environment with the providers, TPAs and employers. Key to success is the affordability and accessibility of the HPS PPO Network. This position oversees network development and the development of strategies that increase market effectiveness and resolve reimbursement issues. The VP of Provider Network will diligently and creatively build and maintain relationships with existing and new provider to ensure both existing and new business relationships will thrive. The VP of Provider Networks will work closely with the Provider Operations team to review root cause issues and engage on higher level interactions as applicable. This role will have a base salary and bonus potential.

Essential Duties and Responsibilities: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Identify provider targets for network development initiatives as well as maintain adequate network coverage of existing specialties and geographic areas
• Strong ability to identify, augment and review data sets and analytics to determine targets for expansion and renegotiation
• Analyze, evaluate, and negotiate new and existing HPS Provider Participation Agreements
• Lead strategy initiatives and implementation of network operations for new products
• Work closely with analytics team in identifying provider trends and new contracting opportunities and new and existing reimbursement models
• Manage all day-to-day activities associated with provider issues working closely with existing team and departments in resolving them
• Oversee network development staff and external consultants in the development of provider networks in Wisconsin
• Monitor HPS Network performance and implement business solutions to address pricing and network coverage gaps
• Lead strategy and implementation initiatives related to network operations for new and existing networks
• Provide support to the PayMedix side of the business as it relates to the Wisconsin market or any future markets that might include a PPO network alongside the PayMedix network (note: this is not a significant portion of the strategy currently)
• Other duties as assigned

Qualifications:

• Ability to think strategically and develop an annual and multi-year plan for the market
• Ability to easily interact with facility Directors and Senior Management and physicians and other allied professionals
• Excellent verbal, written, and presentation skills
• Ability to foster positive and productive work environment along with the ability to show strong leadership skills
• Must have ability to work in a fast-paced environment and work and lead others in an extremely organized and highly detailed manner

Education/Experience:

• Bachelor’s Degree in Business Administration or Health Care Administration with a Master’s Degree in one of these fields preferred
• 10+ years of management level experience in network development
• Previous management experience in hiring and training staff, and assigning network development tasks and priorities

Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• The physical environment requires most employees to work sitting at a desk, using computer and phone equipment
• Periodic travel throughout Wisconsin/Midwest to providers’ locations
• Individuals may be requested to work extra hours and weekends for special projects and events

Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job in this office setting. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to:

• Communicate verbally
• Hear to answer phones, interact with others
• Walk occasionally around the office to perform job duties
• Sit at desk in office environment and home environment to perform duties
• Use fingers to manipulate keyboard and telephone
• Close vision and ability to adjust focus to read and work on computer

Disclaimer: The above information on this description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees assigned to this position.