Director, Provider Network Development (Health Plan)

Job Description

Job Description

Description :

Verda Healthcare, Inc. is a Medicare Advantage Health Plan committed to the belief that healthcare should be easily and equitably accessed by all. Our mission is to ensure that underserved communities have access to health and wellness services, and receive the support needed to live a healthy life that is free of worry and full of joy. We are looking for a Director of Network Development, to join our growing company with many internal opportunities.

Are you ready to join a company that is changing the face of health care across the nation? Verda is looking for people like you who value excellence, integrity, care, and innovation. As an employee, you’ll join a team dedicated to improving the lives of our Medicare members. Our vision incorporates value-based health care that works. We value diversity.

Align your career goals with Verda Healthcare, Inc. and we will support you all the way.

Position Overview

The Director of Network Development serves as the primary source of network recruitment and development for assigned territories, which may change from time to time with targeted providers in an assigned territory. The Director coordinates with the Network Development team to initiate conversations to introduce Verda Health Plan of Texas and to develop communications, with the objective of securing participation agreements in accordance with company policies and procedures.

The Director plays a critical role in increasing Verda’s brand with providers by identifying, researching, vetting and developing an assessment of the provider and the overall business landscape, appropriately identifying providers that align with Verda. This individual also supports provider network growth strategies and provider network development in all markets.

This position reports to the Sr. Director of Provider Network as part of Verda Healthcare, Inc.

Responsibilities :

• Responsible for provider recruitment, provider relations, and provider liaison functions
• Conduct initial outreach and telephonic communication which identify provider interest and qualify them for contracting
• Identify and research resources for developing IPA / Medical group provider leads for new business areas and gaps in provider specialties
• Cultivate a deep understanding of market conditions to determine if practices belong to larger systems that contract single entities
• Participate in quarterly JOCs and in-servicing providers as necessary to fully serve our members as contractually required. Additionally, assist in provider related issues such as eligibility, member benefits, etc.
• Work with Executive leadership team regarding strategy, program development, provider recruitment, contracting and onboarding initiatives
• Development of an adequate provider network in assigned geographical areas
• Develop and cultivate relationships and all provider relations activities in assigned geographically to increase Verda’s brand and footprint
• Report directly to the Sr. Director of Provider Network for status, risks, and potential opportunities in area on a regular basis
• Monitor performance, develop, and implement business solutions to address process and quality gaps, and communicate network strategy and planning
• Ability to travel
• Special Project as assigned

Requirements :

Minimum Qualifications

Bachelor's degree preferred in Business / Economics, Healthcare Administration, or related field

Master’s Degree or equivalent preferred

5+ years minimum experience in managed care contracting (provider relations, provider network development)

Experience with bundled payment contracting or risk and capitation required

Proven track record in negotiations and leading meetings, creating agendas, and

Professional Competencies

Microsoft Office and Intermediate computer skills

Knowledge of Network Management Processes & Services

Ability to manage and prioritize multiple tasks, promote teamwork and fact-based decision making

Communication skills

Ability to work independently and within a team environment

Attention to detail

Familiarity of the healthcare field and local landscape

Critical listening and thinking skills

Training / teaching skills

Strategic and Time management skills

Proper phone etiquette

Decision making / problem solving skills

Resiliency in a changing environment

Demonstrated progression of leadership and responsibility

Ability to work in a fast-paced, start-up culture

Proven ability to build, develop, and lead strong teams of operators

Verda cares deeply about the future, growth, and well-being of its employees. Join our team today!

Job Type : Full-time

Benefits :

401(k)

Paid time off (vacation, holiday, sick leave)

Health insurance

Dental Insurance

Vision insurance

Life insurance

Schedule :

This role is fully remote until we open our Dallas office in Q3 of 2025, and thereafter will be full-time onsite when travel is not required.

Hours of operations : 9am – 6pm

Standard business hours Monday to Friday / weekends as needed

Occasional travel may be required for meetings and training sessions.

Ability to commute / relocate :

Reliably commute or planning to relocate before starting work (Required)

PHYSICAL DEMANDS

Regularly sit / walk at a workstation in an office or cubicle setting. Must occasionally lift and / or move up to 25-50 pounds.

Other duties may be assigned in support of departmental goals.