VP Reimbursement, Provider & Network Programs

Welcome to Highmark Health! We are a leading healthcare company committed to improving the health and well-being of our members and communities. We are seeking a highly qualified and experienced individual to join our team as the Vice President of Reimbursement, Provider & Network Programs. In this role, you will lead a team responsible for managing and developing our reimbursement strategies, provider relationships, and network programs to ensure the delivery of high-quality, cost-effective healthcare services to our members. Our ideal candidate will have a strong background in healthcare reimbursement, provider contracting, and network management, along with excellent leadership and communication skills. If you are passionate about making a positive impact in the healthcare industry and have a track record of driving results, we encourage you to apply for this exciting opportunity.

1. Develop and implement strategic and comprehensive reimbursement plans and policies to ensure effective and efficient healthcare service delivery.
2. Lead and manage a team responsible for negotiating and contracting with healthcare providers to ensure competitive rates and high-quality services for our members.
3. Oversee the development and management of provider networks to ensure adequate access to care for our members.
4. Monitor and analyze reimbursement trends and data to identify areas for improvement and cost-saving opportunities.
5. Collaborate with cross-functional teams to develop innovative solutions and initiatives to enhance provider and network programs.
6. Build and maintain strong relationships with key providers and stakeholders to foster a collaborative and mutually beneficial partnership.
7. Stay current with industry trends and changes in reimbursement regulations and guidelines to ensure compliance and drive continuous improvement.
8. Create and maintain effective communication channels with providers, members, and internal teams to promote transparency and address any issues or concerns.
9. Develop and manage departmental budget and resources to ensure efficient and effective use of company resources.
10. Provide strong leadership and mentorship to team members, fostering a positive and collaborative work environment.
11. Represent the company in external meetings, conferences, and events related to reimbursement and network management.
12. Continuously evaluate and improve processes and procedures to optimize reimbursement and network management operations.
13. Collaborate with other departments to ensure alignment and integration of reimbursement and network strategies with overall company goals.
14. Serve as a subject matter expert on reimbursement and network management matters, providing guidance and support to other teams as needed.
15. Uphold the company's commitment to improving the health and well-being of our members and communities through ethical and responsible business practices.

According to JobzMall, the average salary range for a VP Reimbursement, Provider & Network Programs is $150,000-$250,000 per year. This can vary depending on the specific company, location, and years of experience. Additionally, bonuses and other forms of compensation may also be included in the total salary package for this position.

Highmark Inc. is among the largest health insurers in the United States and the fourth-largest Blue Cross and Blue Shield-affiliated company. Highmark and its diversified businesses and affiliates operate health insurance plans in Pennsylvania, Delaware and West Virginia that serve 5.2 million members. Its diversified health businesses serve group customer and individual health needs across the United States through dental insurance, vision care and other related health businesses. Highmark is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.