[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.

This position will collaborate with InnovAge internal teams - Legal, Compliance, Finance, Claims, Credentialing, and Provider Data Management - to coordinate related activities. The Director, Provider Network is responsible for:

• Contracting, provider education, and provider relations support of all community affiliate health providers.
• Ensuring compliance with contracted terms, access, and availability.

Essential Functions and Work Responsibilities:

• Identifying provider targets and initiating/finalizing provider contracts through the InnovAge contracting process.
• Supporting the Network team as the subject matter expert for large health systems and multi-specialty group practices.
• Building and developing strong relationships within the provider community.
• Collaborating with the Primary Care Team, Center Operations, and Interdisciplinary Teams to identify gaps in the provider network.
• Conducting provider in-services and educating network providers on the InnovAge PACE model of care.
• Utilizing InnovAge PACE approved materials in compliance with state, CMS, and regulatory agencies.
• Communicating updates to providers on changes in practice or process.
• Conducting face-to-face provider service visits.
• Providing the department VP with strategies to close access to care gaps.
• Assisting in addressing provider-related issues in a timely and professional manner.
• Developing and leading provider network growth strategies.
• Building relationships with physicians, specialists, hospitals, and community referral sources.
• Identifying and pursuing new provider partnership opportunities.
• Increasing PACE awareness among providers through training and outreach.
• Working closely with Growth, Operations, Clinical, and Market Leadership teams.
• Tracking provider network performance and developing 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.
• Experience directing provider network contracting, process, and service.
• 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 communicate effectively.
• Exceptional critical thinking ability to adapt to changing business needs.
• 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.