Position Summary:

The Director, Network Development, Orlando Health Network (OHN) manages provider and facility contracting, network development, network analytics, and provider relations functions for executing and maintaining the provider network strategy of OHN. The Director, Network Development will also work in conjunction with OHN operations and clinical teams to meet network growth and performance targets.

Essential Functions

• Contracts and negotiates with primary care and specialty physicians, ancillary providers, and facilities
• Develops and maintains physician fee schedules to support contract development
• Identifies network gaps and partners with analytics resources to fill gaps with high-value providers
• Provides education to OHN physicians/providers/staff on value-based contracts and network fee-for-service contracts
• Conducts site visits to network providers to resolve issues, educate staff on policies, and collect credentialing information
• Leads overall OHN network expansion strategy
• Maintains physician relationships within OHN service area
• Supports OHN performance improvement plans by providing OHN participants with cost and utilization reports, pharmacy profiles, quality care gaps, and other analytics available to improve/maintain provider performance
• Manages incoming provider inquiries and triages to ensure follow-up with provider and internal departments occurs so that identified problems are resolved.
• Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards.
• Maintains compliance with all Orlando Health policies and procedures.

Other Related Functions      

• Strong oral and written communication skills
• Knowledge of professional and facility contracts and reimbursement methodologies
• Strong negotiation skills
• Knowledge of healthcare delivery system and services
• Ability to represent the company with external constituents
• Ability to multi-task
• Demonstrated organizational and analytical skills

Education/Training

• Bachelor's Degree in a related field or equivalent work experience directly related to Network Development or Provider Relations with demonstrated ability to perform the job duties required.

Licensure/Certification

None.

Experience

• 7 or more years of experience in Provider Relations, Network Management, and/or Hospital Contracting.
• 5 or more years of experience in managed care contracting required.
• Previous contract negotiation experience required.