Director, Delivery System Engagement (DSE) Network Optimization Program Management

Reporting to the VP Network Optimization, the Director, DSE Network Optimization Program Management is responsible for leading and distilling large negotiation programs and into distinct projects that drive the efficiency of the Healthfirst Out-of-Network (OON) provider network performance through strategic planning, insight generation, and cross-functional alignment.

This role serves as an advisor and integrator across A/R Optimization, Out-of-Network (OON) and Contracting Optimization functions. The role provides decision support, performance insights, governance structure, and execution visibility to ensure optimization efforts are cohesive and aligned to enterprise priorities across enterprise teams and Delivery System Engagement.

The Director synthesizes data, identifies trends and risks, drives execution and supports leadership decision-making to improve cost of care, provider experience, and network competitiveness.

Responsibilities:

• Develop and maintain the enterprise provider network optimization strategy and roadmap, aligned to organizational priorities.

• Provide structured recommendations, scenario framing, and trade-off analyses to inform decisions made by A/R, OON, and Contracting leadership.

• Translate complex data and input into clear, executive-ready insights and decision support materials.

• Monitor industry trends to inform strategic direction.

• Serve as a central coordination point across optimization functions to ensure alignment of priorities, initiatives, and performance expectations.

• Identify interdependencies, risks, and opportunities across DSE, A/R, OON, and Contracting domains.

• Promote consistency in approaches, assumptions, and performance measurement across teams.

• Helps to define standardized KPIs and performance frameworks across optimization functions.

• Deliver ongoing trend analysis, performance reporting, and risk identification to inform leadership decisions.

• Support teams in translating strategy into coordinated execution plans, without assuming operational ownership.

• Identify opportunities to improve the network optimization operating model.

• Prepare executive-level materials that frame decisions, highlight implications, and clarify trade-offs

• Develop, implement, and own tools and processes for efficient operational and reimbursement management of hospital and physician partners.  

Minimum Requirements:

• A Bachelor’s Degree in business, healthcare administration and/or certifications in operations or program management or related fields

• 8+ years of progressive experience in healthcare, including: strategy, analytics interpretation, provider network management, or operations

• Demonstrated experience in decision support, influencing decision making or transformation roles

• Ability to synthesize complex datasets into clear insights and recommendations

• Experience working with reporting tools and dashboards

• Ability to take complex business problems into clear options and recommendations

• Ability to connect performance trends to strategic implications

• Proven ability to operate effectively in matrixed environments without direct authority

• Experience with Gov’t and proprietary payor reimbursement methodologies and unit cost management

• Strong communication (both verbal and written) and organizational skills

• Ability to work collaboratively, confidently, and influentially with various levels of internal staff and external partners

• Strong data management skills with ability to manage large datasets and create standardized reports.

Preferred Qualifications:

• Master’s in Business or Health Administration

• Project Management Certification

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