Company Statement

For the last 80 years, EmblemHealth has been taking care of New York’s heart and soul, its people. Today, health care is more complex than ever. That’s why we’re at the forefront of change. We work alongside our customers to offer access to high-quality, affordable care, help navigate the health care experience, and make good health achievable; because everyone deserves to be taken care of. We deliver on our mission every day by living our values with our colleagues, members, clients and partners. It begins with caring and respecting all those we work with. We believe a culture of diversity and inclusion is vital to serve our unique and diverse customers. We seek for continues improvement and innovation and believe being agile and nimble is our advantage. We bring a strong sense of partnership to every relationship – internally and externally. The EmblemHealth family of companies offers competitive health, welfare, and retirement benefits as well as incentive pay plans and more.

Provider Network Strategy Leader

📁
Director and Equivalent
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210CE Requisition #
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Serve as an advisor and counselor to department leadership. Provide operational and strategic oversight for the SVP, Provider Network & Population Health, and serve as an integrator for cross-functional planning on major initiatives. Support leadership in overseeing staffing and budget issues and supporting process improvement initiatives. Direct analytics that will inform and drive initiatives, develop ROI metrics to gain executive approval for department projects.

Responsibilities

  • Accountable for positioning the department and leaders to converge around process, issue resolution, project and initiative structure to pull teams together to execute on those. Create matrix environment to implement projects as corp initiatives. Strategic standpoint, funnel projects to committee who defines the project, funneling what we sponsor to accomplish that is directly owned by PNM.
  • Responsible for the central coordination of department activities (operations and planning) and ensuring timely flow of information to and from the SVP to team members and other senior leaders.
  • Advance and/or lead projects that support Provider Network & Population Health and EmblemHealth’s mission, business growth, operational proficiency and financial strength.
  • Support department executive in executing business strategy, enhancing organizational culture, team development and process improvement.
  • Create needed policy changes in response to regulatory and competitive market directives.
  • Respond in real time as projects arise (such renegotiating vaccine administration for covid rates at urgent care centers).
  • Develop and direct strategy and approach to consider what our policies are and what our response to providers will be.
  • Apply critical thinking skills to solve problems with logical and analytical discipline.
  • Create and sustain productive and honest relationships with executives, physicians, leaders, and team members across the organization and in the communities we serve.
  • Facilitate dialogue and work collaboratively with internal departments as needed.
  • Ensure that decisions from external partner meetings are appropriately implemented to meet or exceed goals and expectations.
  • Provide timely reports, benchmarking and presentations showing analyses of how the company compares with industry best practices to develop effective and successful network strategies.

Qualifications

  • BS in management, healthcare administration or relevant field required
  • Master’s degree in business management, healthcare or public administration preferred
  • 10+  years’  of industry-related experience required
  • Knowledge of regulatory guidelines affecting the healthcare industry preferred
  • Effective presentation skills required
  • Ability to manage multi-task operations/projects in a fast-paced changing environment, critical thinking skills required
  • Ability to manage time well between field and in-house days required
  • Excellent interpersonal and relationship building skills required

EEOC Statement

We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.

Sponsorship Statement

Depending on factors such as business unit requirements, the nature of the position, cost and applicable laws and regulations, EmblemHealth may provide work visa sponsorship for certain positions.

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