AVP, Network Access

$204,363 - $255,454/Yr

WelbeHealth - Boston, MA

posted 2 months ago

Full-time - Senior
Boston, MA
Social Assistance

About the position

The AVP, Network Access at WelbeHealth is a pivotal role responsible for ensuring optimal access to care and enhancing the network partner experience across the WelbeHealth PACE program on a national scale. This position is designed for a dynamic leader who will implement a unique approach to network contracting and payment operations, aligning with the core principles of the PACE philosophy. The role requires the ability to design, build, and maintain compliant, multi-state networks and payment operations that support the enterprise goals of improving patient experience and delivering quality care. In this role, the AVP will be accountable for network access and quality, as well as overseeing payments processing and plan operations performance. The individual will be tasked with developing a national network development strategy, engaging in high-level executive negotiations, and spearheading strategic business development efforts. This includes creating the necessary infrastructure to support high-quality networks across multiple states, ensuring that access is maintained across all WelbeHealth programs. The AVP will also focus on exceeding key performance indicators through a network and plan operations model that balances a local-first approach with scalability, compliance, satisfaction, financial outcomes, and consistency. A provider service-centric approach will be championed, fostering an ownership mindset that drives value and delivers a seamless experience for all stakeholders. Additionally, the AVP will develop strategic initiatives aimed at driving participant census growth and sustained enrollment through innovative and high-quality delivery models. Leading a high-performance team that consistently meets goals and collaborates cross-functionally will be a critical aspect of this role.

Responsibilities

  • Accountable for network access and quality, as well as payments processing and plan operations performance.
  • Design and actualize a national network development strategy.
  • Oversee highly elaborate executive negotiations and engage in strategic business development efforts.
  • Develop required infrastructure to support multi-state high-quality networks.
  • Ensure access across all WelbeHealth programs.
  • Exceed key performance indicators through a network and plan operations model.
  • Champion a provider service-centric approach with an ownership mindset.
  • Develop strategic initiatives to drive participant census growth and sustained enrollment.
  • Cultivate and guide a high-performance team known for consistency of meeting goals.

Requirements

  • Bachelor's degree in a relevant field; professional experience may be substituted.
  • Master's degree preferred.
  • Minimum of eight (8) years leading in value-based care or managed care, with direct exposure to network contracting and health plan operations.
  • Minimum of two (2) years of supervisory experience with demonstrated experience mentoring and developing team members.
  • Demonstrated comprehension of intricate market dynamics and synthesizing into impactful strategy benefitting the patient.
  • Experience scaling highly elaborate and regulated operations, preferably in the value-based care setting.
  • Knowledge of payor/provider dynamics.

Benefits

  • 401k + employer match
  • Medical insurance coverage (Medical, Dental, Vision) starting day one of employment
  • 17 days of personal time off (PTO)
  • 12 holidays observed annually
  • Sick time
  • Additional benefits
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