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Lead Director, Provider Performance Value-Based Care

Remote · Canada Full-time

Job Description:

  • establish and maintain productive value-based relationships with key network providers
  • develop and manage the Keystone Value-based Network
  • negotiate high value/risk contracts with complex arrangement structures
  • manage complete value-based contracting cycle
  • work with internal teams to develop a value-based strategic plan
  • oversee contract performance with targeted provider groups
  • evaluate and implement network strategic plans

Requirements:

  • 10 years of related experience
  • comprehensive level of negotiating skills
  • successful track record negotiating value-based contracts with IPAs
  • experience reviewing medical claims data
  • excellent analytical and problem-solving skills
  • strong communication, negotiation, and presentation skills
  • ability to work in a matrixed organization
  • familiarity with legal terms in the context of provider contracting (preferred)
  • experience with CMS Stars and HEDIS technical specifications (preferred)
  • bachelor's degree preferred or a combination of professional work experience and education

Benefits:

  • medical, dental, and vision coverage
  • paid time off
  • retirement savings options
  • wellness programs
  • other resources, based on eligibility

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