Provider Network Director jobs in Hayward, CA

About Our Company

At Altais, we're looking for bold and curious innovators who share our passion for enabling better health care experiences and revolutionizing the healthcare system for physicians, patients, and the clinical community. Doctors today are faced with the reality of spending more time on administrative tasks than caring for patients. Physician burnout and fatigue are an epidemic, and the healthcare experience and quality suffer as a result. At Altais, we’re building breakthrough clinical support tools, technology, and services to let doctors do what they do best: care for people. We invite you to join our growing passionate team as we change the game for the future of healthcare and enable the experience that people need and deserve.

About Your Team

Are you looking to work with a high performing, fast growing and dynamic Contracting team? Altais and our subsidiaries, form one of the most recognized medical groups in California. We are 4,000 physicians, working in over 40 cities in California, caring for more than 500,000 patients. If working in a mission driven organization supporting highly competent, hard-working, thoughtful clinicians who value good ideas and are passionate about reshaping healthcare excites you, then we are thrilled to welcome you to your new career.

This position is located in our brand-new Oakland City Center location, or remotely (within the state of California). We are flexible provided you are open to traveling to the Oakland office locations as needed.

About Your Work

This position is responsible for developing, contributing toward and supporting Altais’s business strategy of revenue maximization, membership growth and retention, network expansion and improved health plan and provider relations as it relates to health plan contracting for a variety of healthcare business types, i.e. medical group, IPA, clinically integrated networks, for all product types; i.e. HMO, PPO, ACO, and for all risk types; i.e. ACO, shared risk, dual risk, global risk.

Primary duties include developing and executing strategy, analyzing contract performance, optimizing payer relations, market analysis and healthcare trends, collaborating with all internal operations teams to maximize performance and revenue earnings, all in pursuit of achieving the overall company strategy goals and initiatives. Additionally, this role will be responsible for leading a team with direct reports.

You will focus on:

• Identify, develop, and implement corporate contracting strategies, business opportunities, and methodologies for contract negotiations, stabilizing health care costs and/or decrease expenses to remain within company budget and align with company objectives.
• Cultivate and maintain strong relationships with payer organizations and health plans.
• Negotiate reimbursement rates, terms and conditions while ensuring compliance with regulatory requirements and industry standards.
• Monitor and analyze payer contract performance, identify opportunities for improvement, and implement strategies to optimize contract outcomes.
• Analysis collaboration with Enterprise Analytics team and other business entities to ensure all upstream and downstream operational impacts are considered and addressed.
• Collaborate cross-functionally with internal teams such as finance, legal, network management, clinical, etc. to ensure seamless implementation and adherence to contract terms.
• Effectively communicate contract details and changes to relevant stakeholders, creating internal and external resources.
• Leads in resolving elevated and complex contractual issues.
• Stay updated on industry trends, market dynamics and regulatory changes affecting payer contracting strategies to make informed decisions and to adapt contracting approaches.
• Participate in external provider meetings and internal operational meetings to continuously improve relationships, processes, operations and best practices.
• Present payer contracting updates routinely to executive stakeholders.
• Responsible for management and training of contracting team on operational changes, department updates and upcoming projects.

The Skills, Experience & Education You Bring
Required Education: Bachelor's degree from accredited 4-year university or equivalent coursework or equivalent experience in managed healthcare related field; Master's degree preferred.
Minimum Experience: This role requires 10 years professional managed healthcare administration experience, with 5 years people management experience in healthcare / contracting related positions

• Experience working in IPA / managed care setting
• Strong financial acumen and analytical skills with the ability to interpret financial and performance data to drive strategic decisions
• Proven track record of successful negotiation and management of complex payer contracts
• In-depth knowledge of healthcare reimbursement methodologies, regulations and compliance requirements.
• Excellent communication, interpersonal and leadership skills
• Extremely strong verbal and written communication skills targeted at both high level external stakeholders as well as internal peers and executives
• Strong management and interpersonal skills to facilitate Contracting team towards achievement of stated functional goals as well as to help develop internal skill sets and performance
• Advanced analytical skills and ability to interpret financial and performance analyses
• Strong negotiation skills and ability to prioritize strategic initiatives relative to constraints inherent to negotiation process
• Advanced knowledge of healthcare, managed care, contract related activities including: negotiations, legal, regulatory, operational, financial and relationship management

You Share Our Mission & Values:

• You are passionate about improving the healthcare experience and want to be part of the Altais mission.
• You are bold and curious- willing to take risks, try new things and be creative.
• You take pride in your work and are accountable for the quality of everything you do, holding yourself and others to a high standard.
• You are compassionate and are known as someone who demonstrates emotional intelligence, considers others when making decisions and always tries to do the right thing.
• You co-create, knowing that we can be better as a team than individuals. You work well with others, collaborating and valuing diversity of thought and perspective.
• You build trust with your colleagues and customers by demonstrating that you are someone who values honesty and transparency.

Altais values the contribution each Team Member brings to our organization. Final determination of a successful candidate’s starting pay will vary based on several factors, including, but not limited to education and experience within the job or the industry. The pay scale listed for this position is generally for candidates that meet the specified qualifications and requirements listed on this job description. Additional pay may be determined for those candidates that exceed these specified qualifications and requirements. We provide a competitive compensation package that recognizes your experience, credentials, and education alongside a robust benefits program to meet your needs.

The anticipated pay range for this role is listed in our salary posting for transparency but may vary based on factors including the candidate’s qualifications, skills, experience, and geographic location. This base pay range is specific to California and can vary based on Bay Area, Metro LA, and Greater California regions which may not be applicable to other locations.

Altais and its subsidiaries and affiliates are committed to protecting the privacy and security of the personal information you provide to us. Please refer to our ‘CPRA Privacy Notice for California Employees and Applicants’ to learn how we collect and process your personal information when you apply for a role with us.

Physical Requirements: Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork – Activity level: Sedentary, frequency most of workday.

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.