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Director Provider Network Development Jobs in Utah

Director of Case Acquisition

Ogden, UT · On-site

$200K - $250K/hr

Provide executive leadership to the Marketing and Case Referral departments. * Develop and coach ... Referral network development * Sales and growth strategy Why Lowe Law Group? At Lowe Law Group, w ...

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Director Provider Network Development information

What are some common challenges faced by a Director of Provider Network Development, and how can they be addressed?

A Director of Provider Network Development often encounters challenges such as negotiating favorable contracts with providers, ensuring network adequacy, and balancing cost control with quality of care. Successfully addressing these issues requires strong relationship-building skills, an in-depth understanding of healthcare regulations, and the ability to analyze market trends. Collaborating closely with legal, compliance, and analytics teams can help streamline contract negotiations and maintain a competitive, high-performing network. Continual professional development and staying current with industry changes are also key for long-term success in this role.

What is the difference between Director Provider Network Development vs Provider Network Manager?

AspectDirector Provider Network DevelopmentProvider Network Manager
CredentialsBachelor's degree, industry certifications often preferredBachelor's degree, relevant certifications beneficial
Work EnvironmentStrategic planning, high-level decision making, cross-department collaborationOperational management, provider relations, network oversight
Employer & Industry UsageHealth insurance companies, managed care organizationsHealth plans, healthcare providers, insurance firms
Search & Comparison IntentStrategic development, network expansion, leadership rolesOperational management, provider relations, network maintenance

The main difference is that the Director Provider Network Development focuses on strategic growth and high-level planning of provider networks, while the Provider Network Manager handles day-to-day operations and provider relations. Both roles require industry knowledge and relevant certifications, but their scope and responsibilities differ significantly.

What are the key skills and qualifications needed to thrive as a Director of Provider Network Development, and why are they important?

To thrive as a Director of Provider Network Development, you need a deep understanding of healthcare networks, contract negotiation, and provider relations, typically supported by a bachelor’s or master’s degree in healthcare administration or a related field. Familiarity with healthcare analytics platforms, provider management systems, and knowledge of payer-provider contract regulations are crucial. Strong leadership, relationship-building, and strategic communication skills set top performers apart. These competencies are vital for building robust provider networks, ensuring compliance, and driving organizational growth in a competitive healthcare environment.

What does a Director of Provider Network Development do?

A Director of Provider Network Development is responsible for building, maintaining, and optimizing relationships with healthcare providers, such as hospitals and physician groups, on behalf of insurance companies or health plans. They negotiate contracts, ensure providers meet quality and cost standards, and help expand the provider network to meet organizational goals. This role often involves analyzing network performance, identifying gaps in coverage, and collaborating with internal teams to improve service delivery and member satisfaction.
What are popular job titles related to Director Provider Network Development jobs in Utah? For Director Provider Network Development jobs in Utah, the most frequently searched job titles are:
What cities in Utah are hiring for Director Provider Network Development jobs? Cities in Utah with the most Director Provider Network Development job openings:
Program Director, Network Innovations

Program Director, Network Innovations

Cambia Health Solutions

Salt Lake City, UT • Hybrid

$113K - $185K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 18 days ago


Cambia Health Solutions rating

8.4

Company rating: 8.4 out of 10

Based on 32 frontline employees who took The Breakroom Quiz

100th of 263 rated insurance


Job description

Program Director, Network Innovations

Hybrid Opportunity within Portland, OR; Medford, OR; Burlington, WA; Spokane, WA; Renton, WA; Vancouver, WA; Salt Lake City, UT; Lewiston, ID; Boise, ID

Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.

Who We Are Looking For:

Every day, Cambia's dedicated team of Program Director Network Innovations are living our mission to make health care easier and lives better. As a member of the Network Innovations team, our Program Director Network Innovations develops and launches complex cross-market programs supporting Provider Partnership Innovation will manage and drive execution to support our specialty Alternative Payment Models., including initiatives like the Cambia Bundled Payment program. This role will support and lead the specialty programs including ongoing program management, program efficiency identification, and overall program(s) execution oversees the complete program lifecycle from development to operational sustainment, ensuring successful outcomes for members, providers, and employers - all in service of making our members' health journeys easier.

Do you have a passion for driving innovation in healthcare partnerships and leading complex, cross-functional initiatives? Do you thrive in building programs from concept to launch while collaborating with diverse stakeholders across markets?Then this role may be the perfect fit.

What You Bring to Cambia:

Qualifications:

  • The Program Director, Provider Partnership would have a bachelor's degree in Business Administration, Healthcare Administration or related field (Master's preferred) and 10+ years of related experience in business or health care management with preference for experience driving transformation programmatic innovation, Alternative Payment Model development, payment innovation and/or strategic implementation or equivalent combination of education and experience.

Skills and Attributes:

  • Alternative Payment Model Leadership: Ability to lead healthcare innovation initiatives with functionally diverse stakeholders across the organization

  • Strategic Communication: Strong facilitation and consensus-building skills with internal/external teams at all organizational levels

  • Healthcare Industry Expertise: Knowledge of industry trends, provider relations, and value-based reimbursement methods

  • Team Leadership: Proven track record managing multi-discipline, high-performance teams and diverse work streams

  • Project & Resource Management: Competency in budgeting, organizing work, establishing success measures, and managing deliverables

  • Business Transformation: Experience initiating and managing complex transformation programs and leading organizational change

  • Business Case Development: Ability to construct actionable business cases and track implementation of new operational processes

  • Strategic Thinking & Partnership: Big-picture perspective with strong relationship-building skills and collaborative team approach

What You Will Do at Cambia:

  • Uses strong knowledge of department strategies and organizational vision to represent Network Innovations in various forums and provide thought leadership for strategic program development

  • Leads Alternative Payment Model program development and integration activities including strategy, design, architecture, quality assurance, customer experience, and operational sustainment

  • Serves as key point of contact with strategic vendors while facilitating operational and strategic interactions with internal and third-party stakeholders

  • Ensures delivery of sustained program interactions with key customer segments (providers, members, employers) and integration with other value-based programs

  • Organizes, motivates, and leads program development efforts with functionally and geographically diverse delivery teams across the company

  • Identifies critical program risks and issues, drives resolution, and ensures requirements and dependencies are communicated to relevant stakeholders

  • Maintains expertise on industry best practices and value-based healthcare innovation while representing Cambia as a leader at conferences and industry events

The expected hiring range for a Program Director Network Innovations is $130,700 - $160,000 depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 15%. The current full salary range for this role is $113,000 - $185,000. #LI-hybrid

About Cambia

Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through.

Why Join the Cambia Team?

At Cambia, you can:

  • Work alongside diverse teams building cutting-edge solutions to transform health care.
  • Earn a competitive salary and enjoy generous benefits while doing work that changes lives.
  • Grow your career with a company committed to helping you succeed.
  • Give back to your community by participating in Cambia-supported outreach programs.
  • Connect with colleagues who share similar interests and backgrounds through our employee resource groups.

We believe a career at Cambia is more than just a paycheck - and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more.

In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include:

  • Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
  • Annual employer contribution to a health savings account.
  • Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
  • Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
  • Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
  • Award-winning wellness programs that reward you for participation.
  • Employee Assistance Fund for those in need.
  • Commute and parking benefits.

Learn more about our benefits.

We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.

We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.

If you need accommodation for any part of the application process because of a medical condition or disability, please email CambiaCareers@cambiahealth.com. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.


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