Director of Network Management

Location: New York, NY

Department: Network Management

Type: Full Time

Min. Experience: Manager/Supervisor

The Company

Integra Partners is a leading, tech-enabled, healthcare benefit management company focused on community-based care. Integra has a core competency in Durable Medical Equipment (DME), Orthotics and Prosthetics (O&P), and works with providers and health plans to facilitate care for hundreds of thousands of patients each year. We have experienced rapid growth with no slowdown in sight.

Our leadership team is amazing (www.accessintegra.com) and focused on what really matters to our business - every employee, every experience, and every customer. With the right people, success is unbounded. This is a truly unique opportunity to take a position with a great company, surrounded by an awesome team.

In 2015, Integra’s management and Tufts Health Plan of Massachusetts acquired the business. Tufts Health Plan is one of the country’s leading, 5-star, private health plans providing healthcare to individuals and employer groups. Integra now operates as a separate financial investment and subsidiary of Tufts Health Plan with a separate board of directors and governance structure. Integra is an innovative and exciting company, with an entrepreneurial culture focused on teamwork and everyday excellence.

 

Scope and Responsibility

Reporting to the COO, the Head of Network Strategy & Operations will be a strategic and operational leader with an ability to effortlessly move between macro and micro operational and business issues. Key areas of responsibility include ensuring Integra Partners has a robust network in existing and emerging markets – capable, available, and dependable providers – to deliver all services contained within the DMEPOS benefit in the geographies we operate. Operationally this includes the entirety of the provider lifecycle: recruitment, credentialing and re-credentialing, training, communications and, as required, termination. Strategically, this includes brand, network composition, mix, geographic expansion, and pricing strategies. We currently have covered lives in 18 states and growing, with meaningful business in the Northeast United States.  Critical to our expansion is having a great network to deliver the DMEPOS benefit.

Integra is looking for a well-rounded and seasoned operations executive who will provide the vision, leadership, know-how, and management skills necessary to create high-performing network development functions. This is a phenomenal leadership position for an experienced, entrepreneurial-minded leader looking to help a high-growth company continue along its strong growth trajectory. Importantly, this leader will be responsible for creating and fostering a high-performance organization that places a premium on delivering high quality work in an efficient and effective manner. This position is in NYC. Some travel will be required.

 

Key Responsibilities and essential functions

Network Operations

  • Oversees Credentialing and Network Development teams – collectively known as Network Operations
  • Sustains and, as required, builds a highly-capable, A+ Network Operations team
  • Handles all human capital management functions required to scale a sales/account Network     Development team and production-oriented Credentialing team
  • Sponsor for technical products that enable Network operations
  • Leverages reporting and forecasting metrics to drive business decisions;  tracking performance against targets and performing variance analyses to clearly articulate production team performance forecasting, and development of contingency plans
  • Sets and manages against key performance indicators (KPIs)
  • Drives operational efficiency through astute operational improvements
  • Implements a culture of continuous process improvement with the ability to foster cross-collaboration among departments and an integrative approach to operations
  • Leads the Network Operations organization through collaboration with the management team
  • Mentors others and represents the leadership team across all departments and functions within the business
  • Stays informed on product information, changes in Medicare/State/Contract funding procedures
  • Executes care transitions
  • Handles all provider escalations and provider account managemen
  • Oversees provider compliance against state and federal regulations, contractual conditions, and stated SLAs
  • Collaborates with customer service to fulfill member needs

 

Network Strategy

  • Works with the CEO and COO to create and deliver Network Strategy to include definition and composition of our network in the geographies we serve and identification and execution of opportunities such as tiering. In other words, defines what “good” looks like in the future and crafts/executes the plan to achieve
  • Shapes and delivers Integra Partners downstream brand strategy
  • Determines and executes geographic growth strategy
  • Analyzes and delineates provider mix, including composition of local, regional, and national providers across all product categories. This includes recruitment strategies and determining network adequacy
  • Defines and operationalizes downstream pricing strategy inclusive of administrative fees and downstream fee schedules

 

Requirements

  • The ideal candidate will easily integrate into an entrepreneurial environment, and will work closely with the executive and management leadership teams. A highly collaborative, consultative, humble, and hungry work style is a must.
  • S/he likely will have a strong understanding of the U.S. healthcare landscape, specifically healthcare plans, payors, and providers. Prior experience with both providers and payors will be highly regarded. Strategic experience coupled with an analytical mind is a plus. The successful candidate will embrace technology as a tool to deliver innovative and efficient results.
  • This leader will communicate a clear vision and have the ability to align and motivate the team towards success. His or her point of view will be critical for success; however, s/he must be curious and consultative rather than dogmatic in sharing such perspective. S/he will measure accomplishments, hold people accountable, and believe that feedback is a gift for professional development for themselves and others alike. The ideal candidate will develop talent and have a track record of developing lasting relationships with peers, customers, direct reports and managers.

 

In terms of the Leadership Characteristics required for the position, we highlight the following:

Understanding the Business

Knows the business and the mission-critical technical and functional skills needed to do the job; understands various types of business propositions and understands how businesses operate in general; learns new methods and technologies easily 

Making Complex Decisions

Can solve even the toughest and most complex of problems; great at gleaning meaning from whatever data is available; is a quick study of the new and different; adds personal wisdom and experience to come to the best conclusion and solution, given the situation; uses multiple problem-solving tools and techniques 

Getting Work Done Through Others

Manages people well; gets the most and best out of the people he/she has; sets and communicates guiding goals; measures accomplishments, holds people accountable, and gives useful feedback; delegates and develops; keeps people informed; provides coaching for today and for the future

Focusing on Action and Outcomes

Attacks everything with drive and energy with an eye on the bottom line; not afraid to initiate action before all the facts are known; drives to finish everything he/she starts

Communicating Effectively

Writes and presents effectively; adjusts to fit the audience and the message; strongly gets a message across

Managing Diverse Relationships

Relates well to a wide variety of diverse styles, types, and classes; open to differences; effective up, down, sideways, inside, and outside; builds diverse networks; quick to find common ground; treats differences fairly and equitably; treats everyone as a preferred customer

Acting with Honor and Character

Is a person of high character; is consistent and acts in line with a clear and visible set of values and beliefs; deals and talks straight; walks his/her talk; is direct and truthful but at the same time can keep confidences

Forward this Position
Recipient email address (one)
Your name
Your email address
Enter a message (optional)
Human Check*
Apply for this Position
* Required fields
First name*
Last name*
Email address*
Location
Phone number*
Resume*

Attach resume as .pdf, .doc, or .docx (limit 2MB) or paste resume

Paste your resume here or attach resume file

Cover Letter*
What’s your highest level of education completed?*
Desired salary*