About the Role

Brighton Health Plan Solutions is seeking an SVP, Network Contracting & Strategy who will have overall leadership and management responsibility for BHPS’s Network Vision, Development, Compliance and Performance. Leveraging existing resources this individual will establish goals and objectives for the Network Department in order to achieve all stated objectives. This includes but is not limited to Health System Contracting, Physician (Large Group and Individual) contracting, ancillary services and other network vendor partner contracting. Additionally, this individual will be responsible for overseeing the strategic assessment and implementation of new BHPS Network Products (e.g., Health System Networks in states outside of the NY/NJ/CT markets). The candidate will be a strategic and operationally oriented Leader with significant experience in assessing Network performance, establishing and achieving Network goals, someone who will help build partnerships with our network partners, bring an analytic mindset to discussions and oversee projects including network development and provider outreach.

Primary Responsibilities

• Develop negotiation strategies and lead negotiations as required to deliver on aggressive financial targets.
• Establishes annual unit costs budget goals for contracts, monitors and reports progress through the year for entire department.
• Facilitate continuous improvement of financial performance, operations, and compliance related to provider contracts.
• Develop long term strategic pricing objectives based on historical contract performance and expected future trends and ensure team of contractors meet performance goals.
• Evaluate financial results and gather market intelligence to identify opportunities to improve performance across lines of business.
• Drive alignment across internal teams on forward-thinking strategies to deliver growth and value to the organization.
• Partner with Sales and Account Management to develop and align market strategies tied to network composition and network products.
• Anticipate customer needs (internal and external), proactively develop solutions to meet them, and forecast the impact of business strategies.
• Manage strategic relationships with partners, both internal and external.
• Provide exceptional team leadership with a focus on employee engagement, development, retention, and attracting top talent into the organization.
• Responsible to ensure adherence to department policies as well as implement new policies and procedures as needed.

Essential Requirements

• Bachelor’s degree.
• Prior experience leading network related department.
• Experience with strategy development and goal setting for network development and contracting
• Experience negotiating and closing contracts with C-Suite and Senior executives with proven results.
• Strategic thinker, goal oriented, ability to work independently and collaboratively across teams.
• Excellent communication and presentation skills.
• At least 10 years related experience.
• Payer and provider experience preferred.
• In depth knowledge of managed care concepts, practices and procedures.
• Must be an expert negotiator with industry knowledge.
• Must have strong financial acumen and a comprehensive understanding of contractual options and healthcare economics.
• Must have strong legal knowledge base to facilitate communication with payer and provider legal teams.
• Must have experience writing, editing, and developing complex contractual documents.

About

At Brighton Health Plan Solutions (BHPS), we’re creating something new and different in health care, and we’d love for you to be part of it. Based in New York City, BHPS is a rapidly growing, entrepreneurial health care enablement company bringing tangible innovation to the health care delivery system. Our team is committed to transforming how health care is accessed and delivered. We believe that cost, quality, and population health are optimized when people have long term relationships with their health care providers – and that’s why we’re creating new products that today do not exist anywhere in the New York/New Jersey market. With a growing labor business under the well-known MagnaCare brand, the launch of Create - a new marketplace of health systems focused on self-insured commercial health plan sponsors, and a successful Casualty business, we’re fiercely committed to positively impacting our partners.

Company Mission

Transform the health plan experience – how health care is accessed and delivered – by bringing outstanding products and services to our partners.

Company Vision

Redefine health care quality and value by aligning the incentives of our partners in powerful and unique ways.

DEI Purpose Statement

At BHPS, we encourage all team members to bring your authentic selves to work with all of your unique abilities. We respect how you experience the world and welcome you to bring the fullness of your lived experience into the workplace. We are building, nurturing and embracing a culture focused on increasing diversity, inclusion and a sense of belonging at every level.

• We are an Equal Opportunity Employer

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