Vice President Provider Relation Credentialing Jobs

Who We Are
Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We've had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it's at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work.
We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at Point32Health.
Job Summary
The Vice President, Strategic Provider Partnerships is a senior functional leader responsible for developing and advancing provider partnership and network strategies that support Point32Health's contracting, product, affordability, and quality goals. This role partners closely with Contracting, Product, Clinical, Operational, and Finance leaders to identify and implement network design, provider program, and investment strategies that improve competitiveness while managing medical expense trends. Establishes network focused growth opportunities in collaboration with Product Line and Product Development leaders.
The Vice President provides strategic and analytical leadership in support of provider contracting, including oversight of network and cost analytics, contribution to the Contracting budget process, and monitoring of cost and utilization trends. The role leads Directors and analytic teams supporting Commercial and Government programs and is accountable for translating priorities into clear strategies, execution plans, and performance expectations for the Provider Partnerships Strategy function.
Job Description
DUTIES/RESPONSIBILITIES - what you will be doing:

• Lead provider partnership and network strategy in support of Contracting, Product, and business line objectives.
• Partner with Contracting and Product leaders to develop annual and multi-year provider strategies aligned to affordability, access, quality, and growth priorities.
• Monitor and evaluate Provider experience and priorities. Collaborate with Provider Performance and Experience team to address pain points and implement innovations that positively differentiate working with P32H from the Provider perspective.
• Oversee development and use of network, cost, and utilization analytics to support contracting and strategic decision-making.
• Design and evolve value-based payment and partnership strategies to improve total cost of care, efficiency, and quality outcomes.
• Develop strategies to grow and optimize the provider network, ensuring geographic adequacy and alignment with product and regulatory requirements.
• Provide execution oversight for priority initiatives, ensuring strategies are translated into implemented programs with measurable results.
• Monitor provider market trends, competitive dynamics, and policy developments to inform network and contracting strategies.
• Lead the strategic use of provider price transparency, benchmarking, and competitive intelligence.
• Provide leadership, coaching, and performance oversight to Directors and their teams.
• Serve as executive sponsor for initiatives owned by Provider Partnerships Strategy, including development of business plans, governance, and risk management as needed.

QUALIFICATIONS - what you need to perform the job
Certification and Licensure

• N/A

Education

• Bachelor's degree in business, health administration, finance, or a related field
• Master's degree or equivalent experience preferred

Experience

• 10+ years of progressively responsible experience in a complex healthcare environment required, health plan experience preferred
• Experience in managed care contracting, provider network strategy, healthcare consulting, or related payer-provider settings required, experience across Commercial and Goverment porgrams preferred
• Demonstrated success leading teams and influencing outcomes in a matrixed organization
• Strong track record of partnering with senior leaders and cross-functional stakeholders

Skill Requirements

• Dynamic and visionary executive with knowledge of network management, value-based contracting, and network analytics
• Deep understanding of provider market trends, health care reimbursement methods, and payment reforms.
• Strong leadership, strategic planning, and negotiation skills.
• Exceptional oral and written communication skills, with a particular focus on presentations to and communications with senior leaders
• Ability to manage and direct multiple priorities across markets while meeting aggressive deadlines
• Self-starter who is comfortable in evolving and/or ambiguous situations; able to maintain constructive behavior in challenging situations

WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS (include special requirements, e.g., lifting, travel):

• Must be able to work under normal office conditions and work from home as required
• Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations
• May be required to work additional hours beyond standard work schedule

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.
Salary Range
$250,000.00 -$300,000.00
Compensation & Total Rewards Overview
The annual base salary range provided for this position represents a range of salaries for this role and similar roles across the organization. The actual salary for this position will be determined by several factors, including the scope and complexity of the role; the skills, education, training, credentials, and experience of the candidate; as well as internal equity. As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company's sole discretion, consistent with the law.
Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:

• Medical, dental and vision coverage
• Retirement plans
• Paid time off
• Employer-paid life and disability insurance with additional buy-up coverage options
• Tuition program
• Well-being benefits
• Full suite of benefits to support career development, individual & family health, and financial health

For more details on our total rewards programs, visit https://www.point32health.org/careers/benefits/
We welcome all
All applicants are welcome and will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
Scam Alert: Point32Health has recently become aware of job posting scams where unauthorized individuals posing as Point32Health recruiters have placed job advertisements and reached out to potential candidates. These advertisements or individuals may ask the applicant to make a payment. Point32Health would never ask an applicant to make a payment related to a job application or job offer, or to pay for workplace equipment. If you have any concerns about the legitimacy of a job posting or recruiting contact, you may contact TA_operations@point32health.org