We are seeking a Vice President, Provider Networks to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.
About the Role:
The Vice President, Provider Networks, plays a critical leadership role in shaping and managing the strategic direction of provider network operations. This position is responsible for developing and maintaining strong relationships with a diverse range of health care providers to ensure high-quality, cost-effective care delivery to members. The role involves overseeing network adequacy, contract negotiations, and provider performance management to optimize network value and patient outcomes. The Vice President will lead cross-functional teams to implement innovative strategies that align with organizational goals and regulatory requirements. Ultimately, this role drives the growth, efficiency, and sustainability of the provider network to support the organization's mission and business objectives.
Minimum Qualifications:
- Bachelor’s degree in Health Administration, Business, or a related field.
- At least 10 years of progressive experience in provider network management within the health care industry.
- Proven experience in contract negotiation and provider relationship management.
- Strong knowledge of health care regulations, payer-provider dynamics, and network adequacy standards.
- Demonstrated leadership experience managing cross-functional teams and driving strategic initiatives.
- Relevant experience may substitute for experience on a year-for-year basis.
Preferred Qualifications:
- Master’s degree in Health Administration, Business Administration, or a related discipline.
- Experience working within managed care organizations or health plans.
- Familiarity with value-based care models and population health management.
- Certification in health care management or related professional credentials.
- Experience with data analytics tools and health care information systems.
Responsibilities:
- Lead the development and execution of provider network strategies to meet organizational goals and regulatory standards.
- Manage contract negotiations and renewals with health care providers, ensuring favorable terms and compliance.
- Oversee provider network performance, including quality metrics, cost management, and member satisfaction.
- Collaborate with internal teams such as claims, medical management, and compliance to ensure seamless network operations.
- Build and maintain strong relationships with providers, industry partners, and regulatory bodies to support network growth and innovation.
- Analyze market trends and competitor activities to identify opportunities for network expansion and improvement.
- Develop and manage budgets, forecasts, and performance reports related to provider network operations.
- Lead, mentor, and develop a high-performing team focused on provider relations and network management.
Skills Required
- Bachelor's degree in Health Administration, Business, or related field
- At least 10 years progressive experience in provider network management within healthcare
- Proven experience in contract negotiation and provider relationship management
- Strong knowledge of health care regulations, payer-provider dynamics, and network adequacy standards
- Demonstrated leadership experience managing cross-functional teams and driving strategic initiatives
- Relevant experience may substitute for experience on a year-for-year basis
- Master's degree in Health Administration, Business Administration, or related discipline
- Experience working within managed care organizations or health plans
- Familiarity with value-based care models and population health management
- Certification in health care management or related professional credentials
- Experience with data analytics tools and health care information systems
What We Do
Independent Living Systems, LLC, offers a comprehensive range of clinical and third-party administrative services to managed care organizations and providers that serve high-cost, complex member populations in the Medicare, Medicaid and Dual-Eligible Market. Independent Living Systems has been an industry leader in managing home and community-based programs for over 16 years. Leveraging ILS’ award winning technology platform, ILS provides assistance beyond the clinical realm at every stage of care from hospitalization to the treatment of chronic illnesses to personalized care management including nutritional support. As one of the country’s leading providers of Nutritional Support Services and medically tailored meals, ILS provides nutrition counseling and home delivered meals for individuals transitioning from acute settings to the home as well as for those combatting the effects of one or more chronic diseases. In partnership with health plans, providers, hospitals, and pharmaceutical and medical device companies, ILS provides solutions aimed at improving health outcomes while rebalancing costs. ILS’ suite of products and services include: MLTSS - Managed Long-Term Services Supports Suite of solutions including assessments, care management, and coordination of home and community-based services, care planning, and back-office support CCM - Comprehensive Care Management A streamlined solution for ongoing care management and care optimization targeted towards special needs populations and special needs plans Meals and Nutrition One of the nation’s largest nutritional providers delivering consistent, high-quality therapeutic meals to elderly and at-risk populations TPA – Third Party Administration A fully integrated business and technology offering to support all administrative and financial reporting requirements of health plans and risk bearing entities MSO – Management Services Organization Population and provider-based interventions to address utilization and monitor unit costs of services For more information please contact us via email at [email protected].
