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Senior Director, Network Operations Strategy

WellSense Health Plan is a nonprofit health insurance company serving members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical Center HealthNet Plan, we provide plans and services that work for our members, no matter their circumstances.

Apply now (https://jobs.silkroad.com/BMCHP/Careers/Apply/MultiForm/294328)

It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.

Job Summary:

Reporting to the SVP Network Management & Operations, the Senior Director, Network Operations Strategy is responsible for the development of the enterprise Network Operations Strategy function with a focus on optimizing overall performance, total value and the tools and processes used to manage the network. This senior leader will be accountable for implementing a network strategy function built on advanced market and provider intelligence and analyses to drive strategic network decisions, such as network pricing/configuration, credentialing, provider engagement, and general department operation functions.

Our Investment in You:

· Full-time remote work

· Competitive salaries

· Excellent benefits

Key Functions/Responsibilities:

• Accountable for the successful execution of multiple, short and long term, large-scale strategic initiatives and projects spanning Network Operations Strategy and the larger organization.

• Provides strategic direction and oversight to staff, projects and daily operations to achieve the highest levels of performance.

• Through the development of productive and collaborative working relationships with internal and external partners and stakeholders, is able to build best in class network support infrastructure and functionality.

• Aligns corporate goals and business strategic initiatives with Network Operations priorities, identifying points of impact. Develops roadmap, gives strategic direction and holds teams accountable for execution of Network Operations initiatives and projects and achievement of corporate and departmental goals.

• Leads and/or participates in cross-functional meetings representing functional needs and concerns.

• Drives performance excellence across all Network Operations Strategy functions by identifying best practices and improving operational efficiency.

• Formulates and oversees the implementation of corrective action plans resulting from internal and external audit findings.

• Develops staff to ensure succession planning at all levels in the organization.

• Other duties as assigned

Supervision Exercised:

· Directly/indirectly manages >50 FTEs on Provider Data Integrity, Provider Engagement and Credentialing teams.

Supervision Received:

· General supervision received weekly.

Qualifications:

Education Required:

· Bachelor’s degree or equivalent combination of education and relevant work experience, including at least 15 years of leadership experience in Network Management, required.

Education Preferred:

· Master’s degree preferred

Experience Required:

· 15 or more years of increasingly responsible leadership experience in Network Management required.

Experience Preferred/Desirable:

· Experience in Medicare/Medicaid lines of business.

Required Licensure, Certification or Conditions of Employment:

· Successful completion of pre-employment background check

Competencies, Skills, and Attributes:

· Exhibits effective, adaptive leadership style that promotes innovation and establishes work priorities

· Uses sound judgment to resolve roadblocks

• Effective collaborative and proven process improvement skills.

· Delegates effectively to develop staff and achieve timely results

· Consistently demonstrates ability to act and react swiftly to continuous change and challenges

· Delivers persuasive messages/arguments based on sound, thorough fact-based analysis and logic to compel senior management teams to act as needed

· Fosters trust with senior leaders, peers and staff

• Strong oral and written communication skills; ability to interact within all levels of the organization.

· Maintains highest personal and professional integrity

• A strong working knowledge of Microsoft Office products.

• Demonstrated ability to successfully plan, organize and manage projects

• Detail oriented, excellent proof reading and editing skills.

Working Conditions and Physical Effort:

• Regular and reliable attendance is an essential function of the position.

• Work is normally performed in a typical remote home office work environment.

• Occasional travel for corporate meetings in Boston or other regions may be required.

• No or very limited physical effort required.

• No or very limited exposure to physical risk.

About WellSense

WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees

Apply now (https://jobs.silkroad.com/BMCHP/Careers/Apply/MultiForm/294328)

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