AVP, Network Access

$204,363 - $255,454/Yr

WelbeHealth - Cheyenne, WY

posted 2 months ago

Full-time - Senior
Cheyenne, WY
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 the performance of payments processing and plan operations. The individual will design and actualize a national network development strategy, oversee complex executive negotiations, engage in strategic business development efforts, and develop the necessary infrastructure to support high-quality networks across multiple states. The goal is to ensure access to all WelbeHealth programs while exceeding key performance indicators through a network and plan operations model that balances local-first approaches with scale, compliance, satisfaction, financial outcomes, and consistency. The AVP will champion a provider service-centric approach, fostering an ownership mindset that delivers a seamless experience and drives value. Additionally, the role involves developing strategic initiatives aimed at driving participant census growth and sustained enrollment through unique and high-quality delivery models. The AVP will also cultivate and guide a high-performance team known for consistently meeting goals, partnering cross-functionally, 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.
  • 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 in 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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