Director Network Pricing

Your career starts now. We’re looking for the next generation of health care 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 health care 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, 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.

Responsibilities:

The Director Network Pricing leads change with key business segments and stakeholders in implementing a new data-driven approach to payment and contract modeling for provider negotiations, standardizing and leveraging best practices across the company to propel an informed and responsive approach to relationships with integrated delivery systems, hospital systems, physician groups, and other provider types. ; Working with actuarial and analytics teams and leveraging centrally governed payment term information, proactively identifies changes and advises of trend impacts.

• Contract modeling and analytics-driven provider negotiation experience, including Value-Based
• Innovate, Implement and Govern standard best-practices on provider payment term management
• Financial Impact analysis and reconciliation.

Education/ Experience:

• Must have a Master's degree in a related field such as Business Administration, Business Analytics, or Public Health
• Five (5) years of Project Management experience - driving major organizational change, coordinating stakeholders in highly matrixed environment and ensuring on-target delivery
• Seven (7) years of Analytics experience - Strategic Applications & Business Intelligence tools
• Optimize, Enhance, and Leverage Large Databases, in coordination with IT
• Candidates will preferably have experience with:
• Provider Payment Determinants – e.g. Fee Schedules, DRGs, EAPGs, Outlier Thresholds, and Chargemasters
• Provider Network Optimization
• Medicaid

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 including remote options, hybrid work schedules, Competitive pay, Paid time off including 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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