Director of Network Management

AHCA/NCAL is seeking a Director of Network Management to improve lives by delivering solutions for quality care. This role will be responsible for managing the day-to-day operations of AHCA/NCAL Solutions contracted network(s). The position is responsible for the Board of Managers, Contracting Committee, Compliance Committee, contract negotiation and implementation, credentialing, and all other administrative functions.

Qualifications & Skills:

Bachelor's degree required, graduate degree in related field preferred. A minimum of five years of health care experience required. Post-acute care knowledge required. Network Development, payer contract, payer negotiation experience is a plus. Project management experience required. Ability to effectively prioritize, plan, manage and execute a variety of projects required.

Duties & Responsibilities:

• Facilitate Board of Managers calls and meetings, including agendas, minutes, and other needs of Managers.
• Manage contract negotiations with payers and lead messenger model activities as required, facilitate contract implementation, and manage existing contracts.
• Educate members on contract terms, policies and procedures and other functions of the network.
• Establish committees including Quality Committee, Contracting Committee, and Compliance Committee.
• Assist in establishing a quality program for the network.
• Assist and troubleshoot contract and payment issues as they relate to network-negotiated contracts.
• Work collaboratively with payers, including on payment resolution and necessary project management to resolve provider payment issues.
• Keep AHCA and state affiliate leadership up to date on network initiatives.
• Collaborate with state affiliates on managed care and population health policy.
• Other duties as assigned.