Job Description

Seeking an experienced Business Leader for the Network Director of Vision Benefits role at Alivi. The Network Director of Vision Benefits will spearhead our Vision benefits product line, which includes Optometry, Optical Eyewear, and Ophthalmology. In this pivotal role, they will be accountable for the Vison product’s strategic direction, growth, and performance.

The Network Director of Vision Benefits will collaborate with cross-functional teams, including sales, marketing, operations, technology, and leadership. Ultimately, working towards accomplishing our established corporate goals.

The Network Director of Vision Benefits will also manage their product team. This product team will support the Network Director on their individual products (i.e., Optometry, Optical Eyewear, and Ophthalmology). The product team will also be accountable for their products provider operations. This includes network development, provider relations, and provider staff model.

Through these multifaceted responsibilities, the Network Director of Vision Benefits will play a crucial role in shaping our company’s success.

DUTIES & RESPONSIBILITIES

Go-To-Market Strategy

· Produce fundamental decisions that shape and guide the organization, with a focus on the future.

· Define the organizational priorities and ensure employees and stakeholders are working towards common goals.

· Identify success criteria and establish agreement around intended outcomes/results.

· Assess and adjust The Vision Network’s direction in response to a changing environment.

· Coordinate and lead strategy planning exercises.

· Track actions and achievements.

· Develop market segmentation and select target markets.

· Strategize and develop value proposition.

· Assist in developing materials that highlight the value proposition of our offerings.

· Manage the budget for Vision benefit Networks, ensuring efficient allocation of resources to achieve strategic objectives.

· Build, maintain, and grow provider networks.

Product Development

· Manage the Vision Benefits product.

· Develop and execute the company’s Vision product strategy in collaboration with SVP, Specialty Benefits Network Operations and other stakeholders.

· Create and maintain a SWOT and feasibility analysis on the Vision Benefit.

· Conduct competitive analysis to identify opportunities and trends in the supplemental benefits industry.

· Analyze competitor offerings and market dynamics to inform product development and marketing strategies.

· Keep up to date on CMS and State initiatives, including ancillary, supplemental, and VBID trends.

· Keep up to date on quality measures, HEDIS, STARS, MRA.

· Collaborate with various teams to define and refine Vision benefits offering, based on market research and member feedback.

· Ensure that services are tailored to meet the unique business needs of our Medicaid and Medicare demographic.

· Execute new market development and expansion.

· Build product technology requirements.

· Join and maintain relationships with product associations.

· Build and manage Clinical Advisory Board Vision Benefits.

Business Development

· Ensure revenue goals are met thru new, up, and cross sales.

· Evaluate, negotiate, and support in securing financially and administratively favorable contracts with new and existing payers.

· Establish and manage C-Level relationships with health plans.

· Client relationship building and management.

· Develop business alliances and sales consultant engagements.

· Support with RFPs, proposals, and payor contracting.

Contract Performance

· Manage existing business contract performance by ensuring operational excellence.

· Coordinate and lead Quarterly Business Reviews (QBR) with internal operations.

· Proven track record of developing and executing strategic plans and achieving key performance metrics (KPI).

· Develop and implement operational policies, procedures, and systems to improve operational efficiency and effectiveness.

· Ensure product profitability by overseeing analysis of claim trend data (i.e., Medicare Run Rate, MLR, claim counts, average claim, visits per thousand members, denial rate) and/or market information to derive conclusions to support contract increases.

· Manage budgeting and forecasting initiatives for product lines to network costs and provider contracts.

REQUIREMENTS & QUALIFICATIONS

· Bachelor’s degree in healthcare management or business.

· 3-5 recent years of experience in a leadership role within the healthcare industry.

· Strong understanding of Vision benefits, regulations, and market dynamics.

· Excellent strategic thinking and problem-solving abilities.

· Effective communication and interpersonal skills

· Demonstrated ability to lead cross-functional teams.

· Experience driving change and growth in within the healthcare industry.

· Proficiency in data analysis and market research tools.

· Ability to travel up to 25%.

Job Type: Full-time