At VillageMD, we are committed to helping patients achieve greater health by delivering the most effective, accessible and efficient healthcare in the world through partnership with primary care physicians. We are in a unique position to impact everyone in primary care from independent, family- owned practices to world-class health systems. We leverage a tested model of care that combines value- based contracting, data-driven decision-making, ancillary services development, and the capital needed for success. Our goal on our Payor Contracting team and across the company is to innovate for the future while retaining the best aspects of the traditional practice of medicine.
Integral to our Chicago Market team, The Network Contract Manager based in Chicago, IL will develop VillageMD’s referral network (physicians, hospitals, pharmacies, ancillary groups & other facilities, etc.) yielding a high functioning network that supports value-based contract objectives. This role with work within our Chicago market. Responsibilities also include establishing and maintaining strong business relationships with health plans and network providers and ensuring the network composition includes an appropriate distribution of provider specialties.
What you might do in your first year:
- Identify gaps in network composition and negotiate contracts with Specialty Providers, Hospitals, Ambulatory Surgery Centers, Skilled Nursing Facilities, other Ancillary Providers,
- Own the end to end contracting process including, but not limited to, using available technology to create contracts, negotiate financial and other business and legal terms, and implement final contract
- Develop optimal negotiation strategies and action steps to yield desired outcome
- Develop incentive-based payment models, as appropriate, to improve quality and efficiency
- Conduct frequent in-person focus visits with providers
- Design and implement programs that build/nurture positive relationships between VillageMD, the health plan, providers and practice managers; serve as primary liaison between providers and VillageMD or health plans to resolve questions and issues as they arise
- Implement training and development of providers through education programs to ensure compliance with VillageMD and health plan policies and procedures
What will make you successful here?
- Ability to be proactive with strong personal initiative as well as highly organized and detail oriented.
- Openness to providing explanations and information to others on difficult issues
- Ability to navigate within ambiguity, a service orientation, and a high level of humility are vital for successful assimilation into our highly collaborative, entrepreneurial culture
- Excellent verbal and written communication skills; ability to convey complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others, including but not limited to reimbursement policy standards
- Strong interpersonal skills, establishing rapport and working well with others
What you bring to VillageMD:
- 5+ years of experience in a network management-related role handling complex provider negotiations with accountability for business results
- Undergraduate degree or equivalent work experience
- Strong knowledge of health care services industry and value-based contracting
- Knowledge of healthcare reimbursement methodologies such Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, .
- Proficient with MS Excel, MS Word, MS PowerPoint
- 2+ years of experience using data analysis skills; ability to construct strategy from the provider data
- Must live within commutable distance of Chicago Market
At VillageMD, we see diversity and inclusion as a source of strength in transforming healthcare. We believe building trust and innovation are best achieved through diverse perspectives. To us, acceptance and respect are rooted in an understanding that people do not experience things in the same way, including our healthcare system. Individuals seeking employment at VillageMD are considered without regard to race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.