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Professional, Provider/Network Program Manager

Headquarters Office, 625 State Street, Schenectady, New York, United States of America Req #431
Thursday, December 19, 2019
Be a part of the transformation at MVP Health Care®. MVP Health Care is a nationally-recognized, regional not-for-profit health insurer. We care for more than 700,000 members across New York and Vermont and are powered by the ideas and energy of more than 1,700 employees. We employ talented people  with diverse backgrounds and experience—tech people, numbers people, even people people—to make health insurance more convenient, more supportive, and more personal. If you’re ready to join a thriving, mission-driven company where you can create your own opportunities—it’s time to make a healthy career move to MVP.


Status: Full-time, Exempt: Yes

This role is responsible for supporting and facilitating network strategy by providing network plan support, creating and managing network programs, participating in business development initiatives, and building network intelligence capabilities. The role focuses on network strategy and targeted business outcomes — clarifying strategic intentions; identifying business outcomes; exploring implications, impacts and risks, preparing reports and analyses; and addressing stakeholder questions. The role will work closely with leadership in Network Management and across the organization to facilitate both strategy and innovation planning resulting in cross-functional efforts to develop enhanced measurement of high-value, high-quality, cost-effective care. Responsibilities to include: • Supporting network intelligence efforts to facilitate contract negotiation, network management, and network strategy development, • Assisting senior leadership in playbook documentation to guide network programs, • Project managing new & existing programs to enhance member retention & growth, • Supporting complex, cross-functional business, process and system analyses aimed at monitoring and managing provider performance to support network strategy that differentiates MVP from its competitors, • Leveraging technology and information to enable the organization's future-state business capabilities, which can enable or alter business processes or practices that, in turn, drive the organizations targeted business outcomes, • Appling existing and new methodologies and analyses to new and evolving network models as well as understands, monetizes and operationalizes new approaches, • Participates in and supports business development. • Represent MVP in internal and external meetings as a program subject matter expert. • In addition to these primary responsibilities, the Network Program Manager will perform other duties as assigned in fulfillment of MVP’s broader VBP and Network Strategy goals. The individual in this role leads deliverables that are valuable to the business, including business requirements, workflow and functional capabilities. Performs other related duties as assigned. POSITION QUALIFICATIONS Minimum Education: Bachelor’s degree in BA/BS in business, health care administration or computer science, information systems, statistics or related field. Equivalent amount of education and related experience considered. Master’s Degree preferred. Minimum Experience: • At least five years of increasing responsibilities with health plan, provider or health care vendor experience. • Minimum of two years’ experience developing and managing programs. • Business development support experience preferred. • Candidates with strong analytics background coupled with network management, healthcare product development/strategy experience preferred. • Prior analytical and reporting experience related to utilization, financial, efficiency and quality data in health care environment strongly preferred. • Experience working with multidiscipline, high-performance work teams. Required Skills: • Naturally inquisitive and a voracious learner. Must enjoy working on challenging, creative and innovative projects and initiatives. • Knowledge of existing, new and emerging methodologies in health care network/payment management (such as value-based payment approaches) and the ability to practically apply them to new business designs and business models. • Strong analytical and conceptual skills; ability to create original concepts and theories for a variety of projects. Experience with Excel and other software solutions such as: Tableau, Power BI, etc. is desirable. • Exhibited skills in leading program management efforts involving the coordination of resources and goals across multiple related projects. • Statistical and information analysis skills. Knowledge of statistical modeling, valuation and metrics development. Knowledge of ETGs and quality measures is desirable. • Exhibited skills in leading program management efforts involving the coordination of resources and goals across multiple related projects. • Experience developing and monitoring delivery of efficient and effective solutions to diverse and complex business problems. • Ability to communicate, present, influence and persuade — both business and IT leaders as well as peers. • Ability to establish and maintain a high level of customer trust and confidence. • Ability to analyze project needs and determine resources needed to meet objectives and solve problems that involve remote and elusive symptoms, often spanning multiple environments in a business area. • Understand business process management, workflow and integration methods and tools.
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MVP Health Care is an Affirmative Action/Equal Opportunity Employer (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com.

Other details

  • Job Family Network Management & Development
  • Pay Type Salary
  • Headquarters Office, 625 State Street, Schenectady, New York, United States of America