General Description
We are seeking a highly skilled professional responsible for identifying business needs, analyzing data, and evaluating market trends to design strategies aligned with organizational goals. This role leads and coordinates effective strategies for health services network management at both local and international levels, with a strong focus on service quality, process improvement, and contractual compliance. The position serves as a key liaison between providers, delegated entities, and internal teams to ensure efficient and strategic network operations.

Essential Functions

Lead internal cross-functional assessment processes and collaborate with operational teams to develop strategies aligned with organizational objectives.

Collect, analyze, and interpret detailed data from multiple sources to support strategic planning and decision-making.

Evaluate provider initiatives involving contracting, compensation, and corporate operations, offering recommendations based on findings.

Negotiate contractual agreements with vendors and providers, ensuring compliance with regulations and strategic alignment.

Monitor and document progress of strategic initiatives from evaluation through implementation.

Review provider and network utilization and performance reports to support continuous improvement and action plans.

Participate in meetings with internal departments, providers, clients, delegated entities, and vendors to communicate trends, projections, and strategic insights.

Oversee end-to-end implementation of network strategies, including leading presentations, managing RFP processes, and coordinating special projects.

Monitor performance of network management vendors and delegated functions using operational and financial indicators; lead performance discussions and corrective action plans when needed.

Collaborate with internal teams to ensure timely resolution of health service issues, quality improvements, and member satisfaction.

Provide insights and data on delegated entities to support business objectives and organizational goals.

Lead relationships with U.S.-based network vendors, coordinating meetings, resolving conflicts, and supporting strategic initiatives.

Education & Experience

Bachelor’s Degree in Business Administration, Finance, Accounting, or a Health-related field.

Minimum of five (5) years of experience performing analytical tasks, managing healthcare-related tariffs, network management, contract negotiation, and healthcare economics.

Required experience in analyzing contracting models.

Equal Opportunity Employer / Disabled / Protected Veterans

The Know Your Rights poster is available here:
https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12.pdf

The pay transparency policy is available here:
https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf

For temporary assignments lasting 13 weeks or longer, AppleOne is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.

We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.

AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.
https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf

We also consider for employment qualified applicants regardless of criminal histories, consistent with legal requirements, including, if applicable, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records, including, if applicable, the San Francisco Fair Chance Ordinance. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.