Exemption Status:

United States of America (Exempt)

$104,286 - $146,000 - $187,714

“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.  A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

Position Summary: 

With one of the largest healthcare networks in the nation, Provider Networks of America (PNOA) delivers convenience, access, and savings to members, and a streamlined experience for providers. Our flexible approach, deep expertise, and direct contract model allows PNOA to offer custom network solutions, hassle-free claims administration, and hands-on support to members and providers.

The Director of Sales & Operations role is responsible for selling our PPO products, the development of the strategic direction of PNOA, and is accountable for the management of contracting and network management activities.  Responsible for developing the network and negotiating and administering contracts.

Sales responsibilities include selling our products to Commercial Group Health TPA’s, Health and Welfare Trust Plans, Workers Compensation TPA’s, Insurance Carriers, Network Aggregators, Bill Review Platforms, and Self-funded Employer Groups. 

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Directly manages both Sales and a Contracting Team, providing leadership and mentoring to their direct reports.
• Identify new revenue producing clients and close new sales
• Create and implement sales plans that successfully achieve business objectives
• Meet sales objectives and targets at profitable rates and moves prospects into implementation.
• Responsible for accurate and timely contract loading and submissions.
• Drive departmental staffing plan, budget, policies and procedures, training programs, and other development as necessary to ensure success.
• Stay informed on marketplace changes and competitive value propositions that will influence network participation and effectiveness.
• Identifying and implementing alternative network initiatives. Supports and provides direction to develop network analytics required for the network solution.
• Assists in resolving elevated and complex provider service complaints. Researches problems and negotiates with internal/external partners/customers to resolve highly complex and/or escalated issues.
• Manages key provider relationships and is accountable for critical interface with providers and business staff.
• Ensures the provider network meets the health care needs of Plan members.
• Augments and modifies the existing provider network to accommodate new products or clients as necessary.
• Leads team in a manner conducive to ongoing growth and expanded knowledge of associates.
• Coach team members in the use of data and appropriate analytical tools that support improved quality.
• Support team members in the identification and creative problem resolution for improved processes and expanded use of technology.
• Systematically keeps staff informed of policy and procedural changes affecting program and administrative operations.

Supervisory Responsibilities 

Manages assigned staff in PNOA. Responsible for the overall direction, coordination, and evaluation of the assigned team. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and discip