Your career starts now. We’re looking for the next generation of healthcare leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Newtown Square, PA, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Role Overview:  The Vice President of Corporate Network Policy and Planning is responsible for developing and managing enterprise-wide policies and processes that support disciplined contracting and provider enrollment for both the corporate and local market network teams. This includes data capture for accurate Facets loading, affordability/Health Value Optimization (HVO) initiatives, provider training/on-boarding, and the configuration of the LIFT platform (Salesforce & Conga) for provider CRM and contract lifecycle management.

Additionally, the VP plays a key role in the Fit-for-Growth capability planning and budgeting process to launch new and/or evolve existing capabilities the Corporate Network team makes available to the local markets.

A deep understanding of network contracting strategies, credentialing, value-based compensation, provider data management and network operations is essential, as well as a expertise related to how network operations and provider data integrity impacts other parts of the enterprise.

 Key Responsibilities:

• Develop, manage, and execute enterprise-wide policies and standardized processes for network contracting and operations.
• Oversee the assessment, development, and implementation of enterprise technology and tools that support the development of competitive and compliant network.
• Serve as product owner for the enterprise-wide multi-year initiative to re-imagine the provider experience/lifecycle management via a new technology platform (Project LIFT) that includes a new contract management system.
• Co-own and drive the company’s vision for establishing a new local-market network operating model by assessing existing people and processes to up-skill the local network teams and move to a broader “network management” mindset versus a traditional focus on provider service.
• Drive a standardized approach to provider contract negotiations with the necessary financial controls and exception approval processes.
• Oversee Provider Communications and Training teams to standardize and consolidate provider-related communications and trainings across all lines of business.
• Conduct surveys and use the feedback/insights captured to favorably impact the provider experience/satisfaction results.
• Manage Network HVO activities and drive the achievement of corporate financial and medical cost reduction goals.
• Oversee Fit-for-Growth and HVO progress reporting.
• Ensure the resources within the department are align to the broader Corporate Network strategy, including CPNM budget development and ongoing monitoring, along with recommendations to restructure and/or redefine roles and responsibilities to meet future market and budget needs.
• Work closely with the teams from Network Pricing and Analytics, New Market Network Development, and Value Base Care / Population Health Analytics.
• Create and influence opportunities to enhance the organization’s agility and scalability for growth and change.
• Provide leadership and direction in resolving escalated, cross-functional issues impacting providers and supporting functions.
• Inform and support the development and implementation of best practices across the provider continuum to ensure optimal outcomes and reduce redundancy between the local and corporate Network teams.

 Organizational Leadership:

• Provide guidance and direction to other functional leaders within the Corporate Network team and partner with the Corporate Network SVP to execute the enterprise network strategy and department goals and objectives.
• Collaborate and influence internal and external stakeholders across all organizational areas.

 Education & Experience:

• Bachelor's degree required. MBA, MHA, MPA degree preferred.
• 10 or more years of experience in healthcare operations with expertise in managed care networks.
• Proven experience interpreting and creating global policies and processes, financial and programmatic budget analysis, and understanding government and regulatory standards.
• Excellent written, oral, and presentation skills.
• Ability to effectively work in a matrixed environment.
• Effective leadership and analytical skills.
• Ability to work collaboratively with internal associates and external stakeholders and drive expedited resolution.

Our Comprehensive Benefits Package

Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays, and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k) tuition reimbursement, and more.