CINQCARE
Vice President, Contracting & Specialized Networks
New York, NY - Full Time
CINQCARE
Vice President, Contracting & Specialized Networks
Position Description
Vice President, Contracting & Specialized Networks
Position Description
Overview
The Vice President of Contracting and Specialized Networks reports to the SVP Provider Relations and Contracting with accountability for providing strategy, judgment, organization, and evidenced-based analysis to influence decisions, and directly to meet CINQCARE requirements. They should embody CINQCARE’s core values, including, Trusted, Empathetic, Committed, Humble, Creative and Community-Minded. At CINQCARE, we don’t have patients or customers – we have Family Members.
This position will coordinate interaction between CINQCARE and key provider and service support types in existing and new markets. Interaction will include, but not be limited to, contracting and partnership discussions, quality and cost performance and membership growth. Additionally, this position will be responsible for deep knowledge of market competitors and their network offerings, to assure that CINQCARE remains competitive.
Job Responsibilities
The Vice President of Contracting and Specialized Networks will have the following responsibilities:
- The design and implementation of network development plans in support of all CINQCARE markets and product lines, with a heightened focus on growing ACO REACH, MLTSS, MAP, PACE, and other targeted vulnerable populations/products; includes traditional medical services and non-traditional support services.
- Directing and overseeing CINQCARE’s ACO REACH network pipeline of prospective practices nationally.
- Developing and overseeing CINQCARE’s FQHC expansion strategy nationally.
- Ensuring geographical competitive, broad access, stable networks that achieve objectives for CINQCARE’s mission, unit cost performance, growth, and trend management targets.
- Evaluation and negotiation of provider/support service(s) contracts in compliance with CINQCARE’s contract templates, reimbursement structure standards, and other key process controls.
- Support payer risk contracting and collaboration/growth initiatives.
- Development and implementation of CINQCARE’s preferred specialty, ancillary and in home care network strategy.
- Evaluation and establishment of network adequacy requirements by service type and market for targeted populations.
- Ensuring CINQCARE specialized networks offer choice.
- Contracting Care Medical FFS payer agreements in CINQCARE markets.
- Building culturally accommodating networks; preferences and needs must be considered.
- Identification and integration of BH providers into CINQCARE’s network strategies
- Collaboration with Market Leads, Legal, Care Management, Finance, and other business areas, as required.
- Support ACO REACH program and other risk programs via the development/contracting of “preferred” referral networks; establish strategic relationships with key network partners in support of these programs (e.g., ambulatory surgery centers, hospitals, etc.).
- All other related duties, as required and defined by CINQCARE’s evolving business needs.
General Duties
The Vice President of Contracting and Specialized Networks will have the following duties:
- Leadership: The Vice President of Contracting and Specialized Networks will lead in defining and executing strategies and solutions to create business value in Network Development and Contracting, including (over time) building a team to design, develop, and execute those strategies and solutions to deliver desired outcomes.
- Strategy: The Vice President of Contracting and Specialized Networks will establish the business strategy and roadmap: (1) improve outcomes for CINQ Care Inc. members; (2) enhance the efficacy of other CINQ Care Inc. business divisions; and (3) develop and deliver external market opportunities for CINQ Care products and services. In establishing the business strategy, the Director Provider Engagement – Key Accounts will define and innovate sustainable revenue models to drive profitability of the Company.
- Collaboration: The Vice President of Contracting and Specialized Networks will ensure that Provider Network capabilities form a cohesive offering, including by working closely with other business divisions to learn their needs, internalize their knowledge, and define solutions to achieve the business objectives of CINQCARE Inc.
- Knowledge: The Vice President of Contracting and Specialized Networks will provide subject matter expertise in Network Contracting solutions, including determining and recommended approaches for developing specialized provider networks, solution deployment and performance evaluation.
- Culture: The Vice President of Contracting and Specialized Networks is accountable for creating a productive, collaborative, safe and inclusive work environment for the Network team and as part of the larger Company.
The Vice President of Contracting and Specialized Networks should have the following qualifications:
- Education: Bachelor’s degree in business administration or other management related field with a record of strong academic achievement;
- Experience: Minimum of 12-15 years’ experience in managed care or other health care related relationship management position(s). Appreciation for details with ability to negotiate, red-line and understand contracts;
- Entrepreneurial: CINQCARE seeks to fix gaps that have persisted for generations in the delivery of care to Black and Brown populations. This position is accountable for ensuring CINQ is positioned to innovatively deliver on its promise by influencing stakeholders and working closely with them to determine acceptable outcomes;
- Communication: Excellent verbal, written communication and presentation skills; ability to clearly articulate and present concepts and models in an accessible manner to CINQCARE’s team, investors, partners, and other stakeholders. Proficiency in all Microsoft Office applications. Excellent planning, organizational, and time management skills;
- Relationships: Ability to build and effectively manage relationships with business leaders and external constituents; and,
- Culture: Good judgement, impeccable ethics, and a strong team player; desire to succeed and grow in a fast-paced, demanding, and entrepreneurial Company.
Location: New York City, with travel to support various CINQCARE markets.
Compensation: $170k - $190k
