eternalHealth, The Next Generation of Medicare ...

VP of NetworketernalHealth - The Next Generation of Medicare AdvantageHealthcare is confusing, but it doesn't need to be. As a consumer-centric health plan based in Boston, MA we are a Medicare Advantage start up that is committed to creating long-lasting partnerships with our members, our providers, and you!About the role: As VP of Network with eternalHealth you will report to the Chief Operations Officer and will be supporting the end-to-end process of building and maintaining a high-quality physician network. A high performing provider network is a critical component of our success, and our relationships with our providers are rooted in trust and transparency. In this highly valued role, you will play an essential part in the full network contracting process, from recruitment strategy to collaborating with our providers on performance improvement initiatives. This external facing role will provide the opportunity to fully understand and communicate eternalHealth's value proposition to our provider partners.We provide a unique opportunity to be a part of a health plan in its beginning stages and by taking advantage of this rare opportunity, you will be able to have insight into all the operations and expertise that is required to run a successful and sustainable plan. Our team members are flexible and able to play different roles, while staying committed to teamwork and collaboration, and passionate about sustainable change.Responsibilities:• Lead the planning and building of a robust and quality provider network.• Partner closely with your team and relevant stakeholders to define and improve the provider recruiting process.• Continuously work to understand the market and needs of our local providers.• Identify and work on growth opportunities in our local markets as well as in markets identified for expansion.• Build out provider networks in new markets by using innovative contract approaches.• Maintain a knowledge base of risk arrangements within contracting, including partial-risk and full-risk agreements.• Manage and improve eternalHealth's workflows and technical processes.• Design and administer policies that comply with state-level contractual and regulatory requirements.• Monitor reports to ensure all necessary compliance and business strategy requirements are maintained.• Ensure that provider networks are in line with network adequacy requirements.• Oversee the credentialing and re-credentialing processes as they happen internally and through third-party vendors.• Develop and enhance provider and hospital relationships through business interactions and outreach.• Assist our network partners in the interpretation of data, technology tools, and analytics.• Work to resolve provider issues in an efficient manner, relating to operational issues, contracting, and patient experience.• Deliver messages to providers including provider education, training, and information about eternalHealth products and strategy, both in recruitment and for existing providers in the eternalHealth network.• Manage and lead members of the Network Team, assisting with their individual success and success of the team.• Proactively elicit provider feedback to improve their overall experience with the Plan.• Maintain strict privacy and confidentiality in accordance with eternalHealth's security standards.• Be able to communicate our brand, values, and differentiators effectively and accurately.Requirements:• Bachelor's degree in relevant field of study (e.g., Business Administration, Biomedical Sciences, Healthcare Operations, Legal Studies)• Minimum of 5 years of experience in managed healthcare, health plan network contractingbuild experience preferred.• Ability to work on-site in our Boston office 5 days a week.• Strong technical skills, including with Microsoft Suite and other collaborative tools.• You're a relationship builder and customer service focused.• Ability to communicate value-propositions in a sales-forward role.• Effectively communicate needs, process improvements and wins, with your network team and C-Suite officers.• Managerial and analytical skills to manage eternalHealth software and hardware• Excellent written, negotiation, and communication skills.• Creative, strategic, and continuously striving for improvement.• Ability to present information to audiences of various skill levels• Flexible and able to ramp-up quickly on different projects in order to support the team as needed in a fast-paced start-up environment.• Ability to think outside the box and offer creative and compliant solutions to existing and new problems.• Strong organization skills to sift through large amounts of data to gain insight on members and market.Preferred:• Experience in client-facing negotiating roles, andor in start-ups, tech, healthcare, or insurance is a plus.• Experience with healthcareprovider operations is a plus.Working with eternalHealth: eternalHealth is an Equal Opportunity Employer which means that we are committed to upholding discrimination-free hiring practices. As a woman-led company, and one committed to diversity at all levels, we strive for an organization of inclusion and acceptance. We are changing healthcare for the better, starting with our own diverse and passionate teams. As an eternalHealth employee you will be empowered to contribute to our teams and strategy, regardless of previous healthcare experience. Our valued team members are encouraged and expected to offer new solutions and creative input, all while keeping in line with eternalHealth's mission, values, and compliance standards.Accommodations: Any eternalHealth applicant will be considered based entirely on their individual qualifications. Should you require reasonable accommodations during the application process (which may include a job-related assessment) please contact us separately at .

Created: 2025-01-14