Director Network Optimization

Job Summary

The Director Network Optimization is a strategic leadership role responsible for managing the cost, quality, and overall performance of the provider network. This role involves developing and implementing strategies to optimize network efficiency, enhance provider performance, and ensure cost-effective care delivery. The Director will work closely with various stakeholders to drive improvements in network operations, maintain regulatory compliance, and support organizational financial goals.

Key Responsibilities

• Develop and execute strategies to manage and reduce network costs while maintaining high standards of care.
• Analyze cost drivers and implement initiatives to optimize cost-effectiveness.
• Implement a comprehensive performance monitoring system to track key metrics such as cost, quality, utilization, and provider satisfaction.
• Identify areas for improvement and lead initiatives to enhance network performance.
• Oversee the negotiation of provider contracts, focusing on terms that balance cost control with quality care.
• Manage contract renewals and ensure compliance with contract terms.
• Utilize data analytics to monitor network performance, identify trends, and make data-driven decisions.
• Provide regular reports to senior leadership on network performance, cost management, and improvement initiatives.
• Ensure all network performance activities comply with federal, state, and local regulations, as well as accreditation standards.
• Stay updated on regulatory changes and adjust strategies accordingly.
• Foster strong relationships with network providers, addressing performance issues, resolving conflicts, and promoting collaboration.
• Develop and implement programs to improve provider engagement and satisfaction.
• Work closely with internal departments such as finance, claims, member services, and quality improvement to align network performance strategies with organizational goals.
• Lead, mentor, and develop a team of network performance professionals.
• Foster a culture of accountability, continuous improvement, and high performance.
  
  

What You'll Need

• Proven track record of successful cost management and network performance improvement.
• Strong understanding of healthcare delivery systems, provider payment methodologies, and regulatory compliance requirements.
• Excellent analytical and problem-solving skills, with the ability to utilize data to drive decision-making and strategy.
• Exceptional negotiation and contract management skills.
• Strong leadership and team development skills, with the ability to engage and motivate a diverse team.
• Effective communication and interpersonal skills, capable of building and maintaining strong relationships with providers, staff, and external partners.
• Ability to travel as required to meet with providers, attend industry events, and represent the organization in various forums.
• Minimum 4-year bachelor's degree in health administration, Business Administration, Finance, or a related field, or equivalent combination or education and relevant work experience.
• Minimum 10 years' experience in healthcare network management, provider relations, or a similar role within a managed care organization, with a focus on cost management and performance improvement
  
  

Location

Our employees are distributed in office locations in multiple markets across the United States. We are unable to hire or allow employees to work outside of the United States.

What LIBERTY Offers

Happy, healthy employees enhance our ability to assist our members and contribute more actively to their society. That’s why LIBERTY offers competitive and attractive benefit packages for their employees. We strive to care for employees in positive ways that promotes wellness and productive employees.

Our first-class benefit package supports our employees and their dependents with:

• Competitive pay structure and saving options that help you reach your financial goals
• Excellent 401k retirement benefits available which includes employer match and ability to save via a Roth IRA, plus immediate vesting during Safe Harbor period and professional financial advice through Financial Engines!
• Medical insurance offered with low-cost premium for employee only coverage and LIBERTY subsidizes 50% of dependent coverage for eligible enrolled dependents.
• 100% employer paid dental coverage for employees and eligible dependents.
• 100% employer paid vision coverage for employee only coverage, low-cost premium for dependents!
• Company paid basic life and AD&D coverage; options to elect additional supplemental coverage.
• Long Term Disability coverage
• Expansive wellness program including companywide Get Active challenges and Burn-A-Long with option for gym discounts.
• Employee Assistance Program
• Generous vacation and sick leave with the ability to roll time over.
• 10 paid company holidays
• Tuition Reimbursement
• Remote or Hybrid options for various positions
• And so much more...
  
  

Compensation

In the spirit of pay transparency, we are excited to share the base salary for this position is $129,099 - $150,000 , exclusive of fringe benefits or potential bonuses. If you are hired at LIBERTY, your final base salary compensation will be determined based on factors such as geographic location, skills, education, and/or experience. In addition to those factors – we believe in the importance of pay equity and consider internal equity of our current team members as a part of any, final offer. Please keep in mind that the range mentioned above is the full base salary range for the role. Hiring at the maximum of the range would not be typical in order to allow for future & continued salary growth.

LIBERTY Dental Plan commits to maintaining a work environment that acknowledges all individuals within the workplace and will continue to engage in practices that are inclusive of all backgrounds, experiences, and perspectives. We strive to have every person within the organization have a sense of belonging while encouraging individuals to unleash their full potential. LIBERTY will leverage diverse perspectives in building high performance teams and organizational culture.

LIBERTYDental Plan will continue to strengthen and develop external partnerships by providing equitable health care access and improving population health in the communities we serve.

We comply with all applicable laws and regulations on non-discrimination in employment, recruitment, promotions, and transfers, as well as work authorization and employment eligibility verification requirements.

Sponsorship and Relocation Specifications

LIBERTY Dental Plan is an Equal Opportunity Employer / VETS / Disabled.

No relocation assistance or sponsorship available at this time