CompIQ Solutions
CompIQ continues to be the most compliant and agile workers compensation bill review platform in the market.
Director, PPO Network Solutions
Location
South Carolina
Posted
46 days ago
Salary
Not specified
Bachelor Degree7 yrs expEnglish
Job Description
• Develop and execute strategies for building and maintaining strong relationships with network vendors and providers to align with the objectives of the network solutions product.
• Lead cross-functional collaboration between vendors, internal teams, and stakeholders to ensure seamless integration and goal alignment.
• Oversee data management and analysis processes, ensuring team accuracy in provider contracts, pricing, and performance metrics.
• Direct the preparation and review of network performance data to identify trends, cost-saving opportunities, and areas for improvement, providing strategic recommendations.
• Supervise the review and negotiation of contracts and pricing agreements to ensure compliance, accuracy, and resolution of issues with network partners.
• Guide research initiatives to identify potential providers and gather market intelligence, leveraging insights to expand network capabilities.
• Monitor industry trends, state fee schedules, and best practices to inform high-level decision-making and policy development.
• Manage data governance and workflow optimization, promoting efficiency and accuracy across the team.
• Collaborate with executive leadership and cross-functional teams to spearhead network initiatives and elevate client experience.
• Review and approve regular reports on network performance metrics, presenting findings to senior stakeholders and driving improvement strategies.
• Formulate and implement strategies to optimize network performance, achieve organizational goals, and scale operations.
• Identify and pursue new opportunities for expanding the network solutions product, including strategic partnerships, mergers, or innovative service offerings.
• Mentor and manage Network Solutions Representatives, including recruitment, performance evaluations, and professional development.
• Collaborate with executive management to align departmental strategies with the organization's growth objectives, remaining adaptable to evolving business needs.
Job Requirements
- Bachelor’s degree in Business, Healthcare Administration, or a related field is required; Master’s degree (e.g., MBA, MHA) or relevant certifications (e.g., CHC, CPC) preferred.
- 7-10 years of progressive experience in network management, healthcare, or a related industry, with at least 3-5 years in a leadership or managerial role.
- Demonstrated expertise in data management, analysis, and strategic planning.
- In-depth knowledge of healthcare networks, vendor relations, regulatory compliance, ancillary services, and state fee schedules.
- Proven track record of leading teams, driving revenue growth, and managing vendor partnerships.
- Strong ability to work collaboratively in a team environment while providing independent strategic direction.
- Commitment to ongoing professional development and staying current with industry trends.
Benefits
- Fair and Competitive Salary
- Flexible schedule in a hybrid or remote-work environment (depending on location)
- Flexible Paid Time Off
- Paid Parental Leave
- Tuition Reimbursement
- Identity Theft Protection
- Medical, Dental, and Vision Insurance
- 100% Company-paid Short-Term and Long-Term Disability
- 100% Company-paid Life Insurance with additional voluntary enrollment options
- Employee Assistance Programs including counseling with up to 6 complimentary sessions
- Monthly Wellness (Gym Membership) Stipend
- Health Spending Account (HSA) and Flexible Spending Account (FSA) Programs
- 401(k) Plan with a 100% vested company match
- Career development and growth opportunities
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