Director, Network Strategy & Planning
 EmblemHealth | |
 United States, New York, New York | |
 Aug 20, 2025 | |
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Summary of Job Summary of Job Responsible for developing, managing, and executing Network-wide policies and standardized processes that impact the entire provider continuum including: network strategy and planning; performance monitoring; and integration activities within and outside the organization. Influence provider-related operations and processes at all organizational levels, including product, and operation. Oversee strategic and budgeting functions for the delivery system and optimal operating model. Build trust and establish stakeholder relationships focused on open communication with Enterprise and external leaders. Responsibilities * Oversee the assessment, development, and implementation of enterprise policies, including controls that drive processes across the provider continuum to ensure standardized, financially transparent processes. * Serve as Project manager for the enterprise-wide multi-year initiatives * Oversee strategic and budgeting functions. Optimize cross-departmental functions and operations. * Drive a standard process to enhance optimization, and standardization of provider-related activities. * Conduct research, solution development, financial modeling, implementation management, reporting, training, and communications. * Drive a standardized approach to provider contract negotiations with controlled, consistent exception processes. * Support an enhanced operating model, serving as a recognized change agent for the enterprise by influencing acceptance of change and defining an appropriate implementation plan. * Provide leadership with support and direction in resolving escalated, cross-functional issues impacting providers and supporting functions. * Inform and support the development and implementation of best practices across the provider continuum to ensure coordination for optimal outcomes and reduce redundancy. * Create and influence opportunities to enhance the organization's agility and scalability for growth and change. * Provide guidance and direction to other functional leaders within the Network and act on behalf of the Network SVP within the Network department and externally to other corporate departments. * Collaborate and influence internal and external stakeholders across all organizational areas, including Business Development, Contracting, Provider Performance, Pricing, Actuary, Communications, Training, Human Resources, Government Relations, IT, Legal, Regulatory, Compliance, and Products. * Assess and redefine provider satisfaction and demonstrable avenues to materially impact results. Qualifications * Bachelor's degree (Required); Master's degree (Preferred) * Project Management (PMI) certification (Preferred) * 10 - 12+ years of relevant, professional work experience (Required) * Working knowledge of healthcare regulatory requirements/environment (Required) * Proven track record of project management with large (department/divisional/enterprise) projects, from strategizing to implementation (Required) * Ability to identify and discern indicators of success for network strategy implementation(s) (Required) * Staff and process management experience (Required) * Ability to establish, maintain, and enhance relationships (Required) * A deep understanding of managed care, network contracting, and operations and their impacts across the enterprise, and external stakeholders (Required) * Strong communication skills (verbal, written, interpersonal, presentation) will all types/levels of audiences (Required) * Proficient with MS Office - Word, Excel, PowerPoint, Outlook, Teams, SharePoint, etc. (Required) Additional Information
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