[Hiring] Director, Provider Network @InnovAge

Role Description

Under the direction of the Vice President, Provider Growth and Network Strategy, this role manages the development and sustainability of the community affiliate health provider network. Responsible for sourcing and the introduction of InnovAge PACE to the provider community.

• Works in collaboration with primary care, center operations, and operations leadership to identify and contract with community affiliate providers to meet the complex needs of the InnovAge PACE participants.
• Collaborates with InnovAge internal teams - Legal, Compliance, Finance, Claims, Credentialing, and Provider Data Management - to coordinate related activities.
• Responsible for contracting, provider education, and provider relations support of all community affiliate health providers.
• Acts as the central external facing resource providing provider and operational support to community affiliate health providers.

Essential Functions and Work Responsibilities:

• Identifying provider targets and initiating/finalizing provider contracts through the InnovAge contracting process.
• Supports the Network team as the subject matter expert for large health systems and multi-specialty group practices.
• Builds and develops strong relationships within the provider community.
• Works in collaboration with the Primary Care Team, Center Operations, and Interdisciplinary Teams to identify gaps in the provider network.
• Conducts provider in-services and educates network providers on the InnovAge PACE model of care.
• Utilizes InnovAge PACE approved materials that comply with state, CMS, and other regulatory agencies.
• Communicates and updates providers on changes in practice or process.
• Conducts face-to-face provider service visits.
• Provides the department VP with strategies to close access to care gaps.
• Assists in addressing provider-related issues in a timely and professional manner.
• Develops and leads provider network growth strategies.
• Builds and grows relationships with physicians, specialists, hospitals, health systems, and community referral sources.
• Identifies and pursues new provider partnership opportunities.
• Increases PACE awareness among providers through training and outreach.
• Works closely with Growth, Operations, Clinical, and Market Leadership teams.
• Tracks provider network performance and develops targeted plans to increase engagement.

Qualifications

• Bachelor’s degree from an accredited college or university in an appropriate discipline (e.g., Business, Healthcare Administration, Public Health).
• A minimum of 8 years’ experience with network development and management.
• Complex contracting and provider relations experience is required.
• Experience directing provider network contracting, process, and service is essential.
• Experience with managed care contracting and provider relations.
• Previous experience with Medicare and Medicaid is preferred.

Requirements

• Must be computer proficient and possess experience with Microsoft Word, Excel, and Outlook.
• Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
• Able to analyze data and statistics and draw reasonable conclusions.
• Ability to read, analyze, and interpret regulations and other documents.
• Strong interpersonal skills and ability to effectively communicate with co-workers and others.
• Exceptional critical thinking ability to adapt to changing business needs.
• Organized, detail-oriented, and able to balance multiple tasks in a fast-paced environment.
• Ability to work sensitively and effectively with individuals of diverse backgrounds.

Benefits

• Medical/dental/vision insurance.
• Short and long-term disability.
• Life insurance and AD&D.
• Supplemental life insurance.
• Flexible spending accounts.
• 401(k) savings.
• Paid time off.
• Company-paid holidays.