CompIQ Solutions

CompIQ continues to be the most compliant and agile workers compensation bill review platform in the market.

Director, PPO Network Solutions

DirectorDirectorFull TimeRemoteTeam 51-200Since 2003H1B No SponsorCompany SiteLinkedIn

Location

South Carolina

Posted

45 days ago

Salary

Not specified

Bachelor Degree7 yrs expEnglish

Job Description

• Develop and execute strategies for building and maintaining strong relationships with network vendors and providers to align with the objectives of the network solutions product. • Lead cross-functional collaboration between vendors, internal teams, and stakeholders to ensure seamless integration and goal alignment. • Oversee data management and analysis processes, ensuring team accuracy in provider contracts, pricing, and performance metrics. • Direct the preparation and review of network performance data to identify trends, cost-saving opportunities, and areas for improvement, providing strategic recommendations. • Supervise the review and negotiation of contracts and pricing agreements to ensure compliance, accuracy, and resolution of issues with network partners. • Guide research initiatives to identify potential providers and gather market intelligence, leveraging insights to expand network capabilities. • Monitor industry trends, state fee schedules, and best practices to inform high-level decision-making and policy development. • Manage data governance and workflow optimization, promoting efficiency and accuracy across the team. • Collaborate with executive leadership and cross-functional teams to spearhead network initiatives and elevate client experience. • Review and approve regular reports on network performance metrics, presenting findings to senior stakeholders and driving improvement strategies. • Formulate and implement strategies to optimize network performance, achieve organizational goals, and scale operations. • Identify and pursue new opportunities for expanding the network solutions product, including strategic partnerships, mergers, or innovative service offerings. • Mentor and manage Network Solutions Representatives, including recruitment, performance evaluations, and professional development. • Collaborate with executive management to align departmental strategies with the organization's growth objectives, remaining adaptable to evolving business needs.

Job Requirements

  • Bachelor’s degree in Business, Healthcare Administration, or a related field is required; Master’s degree (e.g., MBA, MHA) or relevant certifications (e.g., CHC, CPC) preferred.
  • 7-10 years of progressive experience in network management, healthcare, or a related industry, with at least 3-5 years in a leadership or managerial role.
  • Demonstrated expertise in data management, analysis, and strategic planning.
  • In-depth knowledge of healthcare networks, vendor relations, regulatory compliance, ancillary services, and state fee schedules.
  • Proven track record of leading teams, driving revenue growth, and managing vendor partnerships.
  • Strong ability to work collaboratively in a team environment while providing independent strategic direction.
  • Commitment to ongoing professional development and staying current with industry trends.

Benefits

  • Fair and Competitive Salary
  • Flexible schedule in a hybrid or remote-work environment (depending on location)
  • Flexible Paid Time Off
  • Paid Parental Leave
  • Tuition Reimbursement
  • Identity Theft Protection
  • Medical, Dental, and Vision Insurance
  • 100% Company-paid Short-Term and Long-Term Disability
  • 100% Company-paid Life Insurance with additional voluntary enrollment options
  • Employee Assistance Programs including counseling with up to 6 complimentary sessions
  • Monthly Wellness (Gym Membership) Stipend
  • Health Spending Account (HSA) and Flexible Spending Account (FSA) Programs
  • 401(k) Plan with a 100% vested company match
  • Career development and growth opportunities

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