Director, Network Development

Company: Shelby American, Inc.
Location: Huntington Beach
Posted on: April 4, 2025

Job Description:

All Jobs > Director, Network DevelopmentVerda Healthcare, Inc. is a Medicare Advantage Health Plan committed to the belief that healthcare should be easily and equitably accessed by all. Our mission is to ensure that underserved communities have access to health and wellness services, and receive the support needed to live a healthy life that is free of worry and full of joy. We are looking for a Director of Network Development to join our growing company with many internal opportunities.Are you ready to join a company that is changing the face of health care across the nation? Verda is looking for people like you who value excellence, integrity, care, and innovation. As an employee, you'll join a team dedicated to improving the lives of our Medicare members. Our vision incorporates value-based health care that works. We value diversity.Align your career goals with Verda Healthcare, Inc. and we will support you all the way.Position OverviewThe Director of Network Development serves as the primary source of network recruitment and development for assigned territories, which may change from time to time with targeted providers in an assigned territory. The Director coordinates with the Network Development team to initiate conversations to introduce Verda Health Plan of Texas and to develop communications, with the objective of securing participation agreements in accordance with company policies and procedures.The Director plays a critical role in increasing Verda's brand with providers by identifying, researching, vetting and developing an assessment of the provider and the overall business landscape, appropriately identifying providers that align with Verda. This individual also supports provider network growth strategies and provider network development in all markets.This position reports to the Sr. Director of Provider Network as part of Verda Healthcare, Inc.Responsibilities:

• Responsible for provider recruitment, provider relations, and provider liaison functions
• Conduct initial outreach and telephonic communication which identify provider interest and qualify them for contracting
• Identify and research resources for developing IPA/Medical group provider leads for new business areas and gaps in provider specialties
• Cultivate a deep understanding of market conditions to determine if practices belong to larger systems that contract single entities
• Participate in quarterly JOCs and in-servicing providers as necessary to fully serve our members as contractually required. Additionally, assist in provider related issues such as eligibility, member benefits, etc.
• Work with Executive leadership team regarding strategy, program development, provider recruitment, contracting and onboarding initiatives
• Development of an adequate provider network in assigned geographical areas
• Develop and cultivate relationships and all provider relations activities in assigned geographically to increase Verda's brand and footprint
• Report directly to the Sr. Director of Provider Network for status, risks, and potential opportunities in area on a regular basis
• Monitor performance, develop, and implement business solutions to address process and quality gaps, and communicate network strategy and planning
• Ability to travel
• Special Project as assignedMinimum Qualifications
  • Bachelor's degree preferred in Business/Economics, Healthcare Administration, or related field
  • Master's Degree or equivalent preferred
  • 5+ years minimum experience in managed care contracting (provider relations, provider network development)
  • Experience with bundled payment contracting or risk and capitation required
  • Proven track record in negotiations and leading meetings, creating agendas, and
  • Microsoft Office and Intermediate computer skills
  • Knowledge of Network Management Processes & Services
  • Ability to manage and prioritize multiple tasks, promote teamwork and fact-based decision making
  • Ability to work independently and within a team environment
  • Familiarity of the healthcare field and local landscape
  • Critical listening and thinking skills
  • Training/teaching skills
  • Strategic and Time management skills
  • Resiliency in a changing environment
  • Demonstrated progression of leadership and responsibility
  • Ability to work in a fast-paced, start-up culture
  • Proven ability to build, develop, and lead strong teams of operatorsVerda cares deeply about the future, growth, and well-being of its employees. Join our team today!Job Type: Full-time
    • 401(k)
    • Paid time off
    • Health insurance
    • Vision insurance
    • Life insuranceSchedule:
      • Full-time onsite
      • Hours of operations: 9am - 6pm
      • Standard business hours Monday to Friday/weekends as needed
      • Occasional travel may be required for meetings and training sessions.Ability to commute/relocate:
        • Reliably commute or planning to relocate before starting work (Required)PHYSICAL DEMANDSRegularly sit/walk at a workstation in an office or cubicle setting. Must occasionally lift and/or move up to 25-50 pounds.*Other duties may be assigned in support of departmental goals.
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Keywords: Shelby American, Inc., San Diego , Director, Network Development, Executive , Huntington Beach, California