Principal, Provider Network Transition Strategy
Core
Enterprise leader responsible for developing and advancing strategy for significant provider network changes and disruption events to ensure organizational readiness and mitigate risk.
Role type
Principal, Provider Network Transition Strategy
Builds
Enterprise alignment, mitigation strategies, and coordinated responses for provider network transitions
Domain
Healthcare (Medicare Advantage/Medicaid), Provider Network Management
Deliverable
client delivery
Required skills
Provider network operations, provider contracting strategy, healthcare delivery systems, cross-functional leadership, executive influence, data analytics, regulatory compliance, strategic program management
Preferred skills
Bachelor's degree, complex regulatory navigation, member experience optimization
Technologies
Data analytics tools, reporting systems
Responsibilities
Lead enterprise strategy for provider network transition and disruption management; Serve as enterprise lead for provider termination programs; Partner with cross-functional teams to develop mitigation strategies; Proactively identify emerging provider network risks; Drive initiatives to improve provider and member experiences during network changes; Facilitate executive governance and decision-making processes; Develop enterprise visibility into significant provider network events through reporting and analytics; Utilize data to evaluate downstream impacts on member retention and network adequacy; Lead cross-functional efforts to simplify processes and strengthen enterprise capabilities; Advise senior leaders on strategic initiatives and organizational risks.
Seniority
Principal, hands-on IC with strategic leadership