Senior Director, Provider Account Management

Overview:
Equality Health, LLC is a Phoenix-based whole-health delivery system focused on transforming value-based care delivery with population specific programs that improve access, quality, and member trust. Our mission is to ensure diverse populations receive quality healthcare that improves and enriches their lives. Through an integrated technology and services platform, culturally competent provider network and personalized care model, Equality Health helps managed care plans and health systems improve outcomes for diverse populations while simultaneously making the transition to risk-based accountability.

Position Summary:

The Senior Director, Provider Account Management is responsible for network expansion, provider relationship management,and the administrative functions relating to provider network recruitment, development, and relationship management for the assigned territories within the Tennessee market. This position will provide oversight to Provider Account Managers, including identifying provider network targets, delivering effective recruitment strategies,refining recruitment activities and processes, and managing the network to maximize performance and retention of network providers. This individual will work both autonomously and collaboratively with other Equality Health (EQH) leaders and team members, demonstrating a commitment toward shared goals, strategic objectives, and the administration of organizational policies and procedures.

*Candidate must reside in Tennessee, preferably Nashville or Memphis areas*

Responsibilities:

• Participate in all phases of provider recruitment including: outreach, development of provider communication strategies, provider recruitment document preparation, follow-up with providers, and securing executed contracts
• Implement and develop strategies for prospective provider recruitment and contracting for Provider Account Managers' geographic territories
• Promote, maintain, and manage team goals and objectives through effective hiring, performance management, coaching, and career development
• Regional travel up to 30% via personal automobile or air travel; occasional overnight stays required.
• Collaborate interdepartmentally for new and existing network services expansion
• Manage and conduct effective and efficient contract negotiations, and develop strategies, tactics, and methods for specific network development initiatives
• Review, assess, and continuously identify methods for improving Equality Health's network development/growth processes and procedures
• Support Provider Account Management team members to create a strong recruitment pipeline and ensure existing practices/provider networks also generate new growth in existing lines of business (LOB)
• Support EQH market research for the effective creation and implementation of the network's lead generation initiatives
• Create long and short-term plans, including setting targets for milestones and adhering to deadlines for EQH market specific strategic priority initiatives
• Lead onboarding activities for newly contracted providers to ensure that new providers receive timely and effective training on EQH systems, processes, and policies.
• Responsible for developing and maintaining the overall relationship between EQH and all providers, including, but not limited to: (a) ensuring that all network providers receive timely and accurate responses to inquiries and concerns, (b) oversight of provider performance in EQH's programs, (c) tracking incentive payments to ensure providers receive timely and accurate payments, and (d) managing a regular cadence of interactions with all network providers.
• Responsible for ensuring the provider recruitment database and documentation is accurate in all systems, including CRM
• Collaborate with internal key stakeholders to remove barriers impeding contract negotiations; manage contract implementation; identify opportunities for process improvement and facilitate problem resolution
• Partner with executive team to identify provider issues or complaints; develop and implement a course of action to resolve concerns
• Attend /support conferences, community events, and other development activities as determined by Equality Health
• Provide an excellent customer experience to both new provider leads and existing network providers

Required Knowledge, Education, & Experience:

• Bachelor's degree in Business, Healthcare Administration, or related field of study; or, an equivalent combination of education and/or work experience
• Minimum eight (8) years of experience in a healthcare network development or a directly related position and a minimum three (3) years of experience with provider research and market analysis
• Strong and effective negotiation skills with providers in all practice settings, sizes, and types (small/medium practice, large provider groups, health system provider networks, etc.)
• Demonstrated understanding of risk adjustments and value-based contracting
• Proficiency with Microsoft Office Suite and web-based technologies
• Minimum three (3) years' experience in a managerial or supervisory role

Highly Preferred Skills, Abilities, & Qualifications:

• Familiar with payment alternatives such as fee for service, capitation, global budget, performance compensation and episode of care payment
• Direct personal knowledge of the provider and payer landscapes in one or more major Tennessee metropolitan areas, to include Nashville and Memphis
• Familiar with patient and practice risk adjustment concepts and premium-based payment methodologies
• Familiar with conventional payment methodologies
• Experience with database management in a healthcare setting
• Demonstrated ability to gain trust and compliance from provider and staff and achieve a mutually beneficial outcome
• Excellent problem-solving skills, including the ability to systematically analyze problems, plan, and take action
• Proven experience building and mentoring teams
• Excellent verbal, written and interpersonal communication skills
• Able to convey complex or technical information in a manner that others can understand, and able to understand and interpret complex information from others

Disclaimer: This job description may not be inclusive of all assigned duties and responsibilities, or aspects of the job described, and may be amended at any time at the sole discretion of the employer

Equality Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.