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Your career starts now. We’re looking for the next generation of healthcare leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Newtown Square, PA, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com .

**Position Overview:** **;** The Vice President of Corporate Network Policy and Planning is responsible for developing, managing, and executing enterprise-wide policies and standardized processes that impact the entire provider continuum. This includes network strategy and planning, provider setup in Facets, accurate provider payment, and integration activities within and outside the organization. This role influences provider-related operations and processes at all organizational levels, including corporate, product, and local market. Additionally, the VP oversees strategic and budgeting functions for the delivery system and optimal operating model, managing National Contacts, Network Strategy, Corporate Provider Network Management (CPNM) Communication and Training, and Health Delivery Systems functions. A deep understanding of managed care, network contracting, and operations is essential, as well as their impacts across the enterprise, including health plans and external stakeholders. Building trust and establishing stakeholder relationships focused on open communication with Enterprise and external leaders is critical.

Key Responsibilities:

+ Develop, manage, and execute enterprise-wide policies and standardized processes.

+ Oversee the assessment, development, and implementation of enterprise policies, including controls that drive processes across the provider continuum to ensure standardized, financially transparent processes.

+ Serve as Project Sponsor for the enterprise-wide multi-year initiative to re-imagine provider experience workflow and enable new technology platforms (Project LIFT) and any new enterprise contracting platforms.

+ Drive a standard global Provider Delivery operating model, assessing existing processes and structures at all organizational levels and developing an enterprise approach to enhance integration, optimization, and standardization of provider-related activities.

+ Conduct research, solution development, financial modeling, implementation management, reporting, training, and communications.

+ Drive a standardized approach to provider contract negotiations with controlled, consistent exception processes.

+ Support an enhanced operating model, serving as a recognized change agent for the enterprise by influencing acceptance of change and defining an appropriate implementation plan.

+ Oversee Provider Communications and Training teams to standardize and consolidate provider-related requirements, communications, and training needs to balance fiduciary responsibility while reducing administrative burden.

+ Assess and redefine provider satisfaction and demonstrable avenues to materially impact results.

+ Oversee strategic and budgeting functions.

+ Manage Network Health Value Optimization (HVO) activities and drive the achievement of Corporate financial goals.

+ Oversee national contracting strategy and execution, including management of subcontractor vendor relationships such as NEMT.

+ Align strategic goals for optimizing the Corporate Network function, including CPNM budget development and ongoing monitoring, along with recommendations to restructure and/or redefine roles and responsibilities to meet future market needs.

+ Optimize cross-departmental functions and oversee CPNM operations.

+ Work closely with Network Pricing, Network Development, New Business, and Network Strategy Analytic teams within CPNM.

+ Create and influence opportunities to enhance the organization’s agility and scalability for growth and change.

+ Provide leadership and direction in resolving escalated, cross-functional issues impacting providers and supporting functions.

+ Inform and support the development and implementation of best practices across the provider continuum to ensure coordination for optimal outcomes and reduce redundancy.

+ Provide leadership and direction to integration opportunities impacting provider-related functions with internal and external partners.

Organizational Leadership:

+ Provide guidance and direction to other functional leaders within the Corporate Network and act on behalf of the Corporate Network SVP within the Network department and externally to other corporate departments.

+ Collaborate and influence internal and external stakeholders across all organizational areas, including Business Development, Contracting, Provider Performance, Pricing, Actuary, Communications, Training, Human Resources, Government Relations, IT, Legal, Regulatory, Compliance, and each of our Markets and Products.

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Education & Experience:

+ Bachelor's degree required.

+ MBA, MHA, MPA degree preferred.

+ 10+ years of progressively responsible experience in healthcare operations with expertise in managed care networks.

+ Proven experience interpreting and creating global policies and processes, financial and programmatic budget analysis, and understanding government and regulatory standards.

+ Excellent written, oral, and presentation skills.

+ Ability to effectively work in a matrixed environment.

+ Effective leadership and analytical skills.

+ Ability to work collaboratively with internal associates and external stakeholders and drive expedited resolution.

Diversity, Equity, and Inclusion

At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.; We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays, and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k) tuition reimbursement, and more.

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As a company, we support internal diversity through:

Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.