Director of Network Contacting
Company: Morgan Consulting Resources, Inc. - Healthcare Exe
Posted on: June 22, 2022
Morgan Consulting Resources is an executive search firm focusing
on the Healthcare Industry for 25 years. We have been retained by
P3 Health Partners - California/MedCore HP (P3 HealthPartners) to
conduct a search for a Director of Network Contracting for the
California market. This is an exceptional opportunity to be part of
a fast-growing physician-led organization that keeps patients at
the center of care. This hybrid position is located in Stockton, CA
with some remote work opportunity within the Central Valley.About
the Company:Founded in 2017, P3 Health Partners is a
patient-centered and physician-led population health-management
company. Founded and led by physicians, P3HP is a team of doctors,
clinicians, and support service professionals with a shared passion
and purpose for improving the way patient care is delivered. Their
business strategy is to support providers, care teams, and
practices in their journey from traditional volume-based models to
value-based systems of care and wellness. Through strategic
partnerships, they strive to make healthcare better for millions of
patients and their families, thousands of clinicians and caregivers
and dozens of payers.Currently operating in Nevada, Arizona,
Florida, Oregon, and California, P3HP is also assessing
opportunities in multiple states. They are building scalable care
delivery systems that accept and manage clinical and financial risk
for large patient populations.In January 2022, P3 Health Partners
announced the closing of the company's acquisition of Medcore HP, a
health plan licensed under the California Knox-Keene Health Care
Service Plan Act of 1975, and Omni IPA Medical Group, Inc., an
independent practice association in San Joaquin County, California.
P3 Health Partners is a publicly traded company on the NASDAQ
(PIII). Visit P3HP's website at https://p3hp.org/ for further
information about the company. About the Position:Reporting to the
VP of Contracting with a dotted line to the Market COO, the
Director of Network Contracting will lead the market's contracting
activity and produce outcomes consistent with corporate guidelines
and requirements. The incumbent will be responsible for overseeing
the network expansions and identifying future opportunities. They
will offer technical contracting leadership and expertise. The
Director of Network Contracting will also manage budgeting and
forecasting initiatives for network costs and provider contracts.
We are looking for candidates who are familiar with the provider
community in the Central Valley to assist with expansion to
Sacramento and other areas within the Central Valley down to
Bakersfield, CA.The successful candidate will have experience
- Medicare Advantage population health management;
- Value Based Contracting;
- Fee for Service contracting;
- Capitated rate models; and,
- Medicare Advantage reporting.Membership: 12,500 Medicare
Advantage Members; 2000 commercial members (currently contracted
with three health plans and expecting two more large payor
additions for 2023)Provider size: 117 PCPs and over 300
specialty/ancillary providersTotal staff in Stockton, CA: 60Staff
reporting to this position: 2Travel: Local travel to visit provider
offices Short term goals:
- Geographic expansion into Sacramento and other counties located
within the Central Valley.
- Align PCPs around value-based outcomes (managing the
performance of the network).
- Analyze the network for appropriateness/refinement.
- Work closely with the Provider Engagement staff to roll out new
tools for the physician network to enhance quality and
- Roll out and maintain PQIP (PCP Provider Quality Incentive
- Bachelor's degree; MBA, MHA, or MPH strongly desired.
- Minimum of 10 years of specific work experience in managed care
contracting to include network expansion projects, hospitals,
specialty physician and ancillary contracting.
- Well versed in CMS reimbursement and capitated, per visit, per
diem, DRG, APC, and fee for service methodologies.
- Exceptional provider contracting negotiation
- Oversees assigned staff. Responsibilities include recruiting,
selecting, orienting, and training employees; assigning workload;
planning, monitoring, and appraising job results; and coaching,
counseling, and disciplining employees.
- Responsible for overseeing new network expansions and future
- Negotiates, implements, and manages capitated and
fee-for-service agreements with individually contracted Primary
Care Physicians (PCP), medical groups, hospitals, ancillary
providers, and specialists.
- Analyzes current and projected network needs from
cost/utilization and competitor standpoints.
- Analyzes, negotiates, and drafts contract rate and language
proposals consistent with corporate guidelines for language and
financial and operational performance.
- Oversees administration of the contracts to ensure anticipated
results, identify negative performance trends, and implement cost
containment and other improvement strategies, including PQIP.
- Collaborates with regional executive team and other departments
to ensure contracted network support of operating goals, including
STARS, HEDIS, and Medicare Risk Adjustment, and other
- Oversees any required contract amendments and resolves contract
- Contributes expertise to development of organizational best
- Coordinates managed care contracting for acquisitions and
- Leads cost saving contracting initiatives within assigned
market and initiatives that may lead to cost savings in other P3
markets.Culture:P3HP is highly entrepreneurial and has a supportive
and collaborative team culture interlaced with fun. Candidates with
proven ability to function well within a fast-paced, hands-on and
metrics/data driven environment will excel in the organization. The
culture values always doing the right thing for the patients and
having fun in the process. Innovation is highly encouraged.A
complete position description can be found on our website at
www.morganconsulting.com.Please contact Rosie Saenz at
Keywords: Morgan Consulting Resources, Inc. - Healthcare Exe, Stockton , Director of Network Contacting, Executive , Stockton, California
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