AVP, Network Access

$204,363 - $255,454/Yr

WelbeHealth - Honolulu, HI

posted 2 months ago

Full-time - Mid Level
Honolulu, HI
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 nationally. 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 design, construction, and maintenance of compliant, multi-state networks and payment operations that support enterprise goals focused on patient experience and 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 design and actualize a national network development strategy, engage in strategic business development efforts, and develop the necessary infrastructure to support high-quality networks across multiple states. The AVP will also be responsible for exceeding key performance indicators through a network and plan operations model that balances a local-first approach with scale, compliance, satisfaction, financial outcomes, and consistency. A provider service-centric approach is essential, with an emphasis on delivering a seamless experience that drives value. The AVP will develop strategic initiatives aimed at driving participant census growth and sustained enrollment through innovative and high-quality delivery models. Additionally, the role involves cultivating and guiding a high-performance team known for consistently meeting goals, fostering cross-functional partnerships, and ensuring individual and team satisfaction.

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 to ensure access across all WelbeHealth programs.
  • Exceed key performance indicators through a network and plan operations model that balances local-first approach with scale, compliance, satisfaction, financial outcomes, and consistency.
  • Champion a provider service-centric approach, delivering a seamless experience that drives value.
  • Develop strategic initiatives to drive participant census growth and sustained enrollment through unique and high-quality delivery models.
  • Cultivate and guide a high-performance team known for consistency in meeting goals and partnering cross-functionally.

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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