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VP Ancillary Provider Strategy & Management

Highmark Inc
  • PITTSBURGH, PA
  • Autofill and Review
25 days ago
Highmark Inc

Job Description

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VP Ancillary Provider Strategy & Management

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VP Ancillary Provider Strategy & Management

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501 Penn Avenue, PITTSBURGH PA 15222, United States

Company :

Highmark Inc.

Job Description :

GENERAL OVERVIEW:

Lead and manage the development and maintenance of Highmark's various provider networks for all lines of business and all market segments, with emphasis and ownership of the ancillary networks and multi-market providers. Develop and implement new reimbursement and care delivery models that result in cost trend control, higher care quality, appropriate access, and better member experiences. Create and implement innovative programs and services that integrate contracting strategies with Product, Clinical, and Reimbursement strategies.

ESSENTIAL RESPONSIBILITIES:

  • Oversee contract negotiations and network management programs for ancillary providers and national/multi-market providers. Own and manage contract signatory authority for such provider contracts.

  • Establish appropriate benchmarks and monitor parameters to ensure product and service competitiveness.

  • Facilitate creation and/or adoption of innovative products and services to meet market demands.

  • Develop and implement pay-for-value contracts for a variety of ancillary providers across all markets.

  • Provide oversight for the support of market-based provider initiatives including communications, contract issue resolution, C2V initiatives and high-performance network management.

  • Collaborate with Home & Community Services / Helion to develop and implement a comprehensive network management strategy for post-acute care services with an emphasis on Skilled Nursing, Home Health, Inpatient Rehabilitation, and Long-term Acute Care.

  • Lead and manage successful relationships with all internal stakeholders, particularly, Market-segment leadership, Reimbursement, Product, Payment Innovation, Medical Management, and Sales.

  • Represent Highmark and the Provider Services division to external stakeholders, including Providers, Accounts, Regulatory entities, BCBSA, etc.

  • Other duties as assigned or requested.

QUALIFICATIONS:

Minimum:

  • Bachelor's degree

  • 7 years of experience in healthcare and/or managed care in a management role

  • 7 years of experience in provider contracting, benefit design, medical management, or healthcare administration

Knowledge, Skills and Abilities :

  • Excellent written and verbal communication skills

  • Excellent presentation skills

  • Strength in leadership and teamwork, strategic thinking, influencing skills, negotiating skills, and operations execution.

SCOPE OF RESPONSIBILITY

  • Does this role supervise/manage other employees? Yes

  • If yes, indicate the number of direct reports: 1

WORK ENVIRONMENT

  • Is Travel Required? Yes

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Recruitment Fraud Alert

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Job Details

  • Job category Provider Services
  • Position Type Full Time
  • Posted 10/08/2026
  • Location(s) 501 Penn Avenue, PITTSBURGH PA 15222, United States
  • Line of Business
  • Entity
  • Recruiter
  • Hiring Manager
  • Experience Level
  • Job Family Provider Gen-HM
  • Req ID J288325

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Highmark Health is an independent licensee of the Blue Cross Blue Shield Association.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.

We provide reasonable accommodations to applicants with disabilities or who require accommodations for sincerely held religious beliefs or for known limitations related to pregnancy, childbirth, or related medical conditions. If you need an accommodation, please contact HRServices@highmarkhealth.org. This email is exclusively for accommodation requests under applicable laws.

2026 Highmark Health. All Rights Reserved.

Numbers & Facts

LocationPITTSBURGH, PA
IndustryHealthcare Services
Company Size1,000 to 1,499 employees
Year Founded1996
Websitehttps://www.highmark.com/hmk2/index.shtml

About Company

Highmark provides millions of people with the security of quality health insurance

Our history of helping families and companies with their health insurance needs dates to the 1930s, when our predecessor companies were established to help Pennsylvania's residents pay for health care.

Highmark was created in 1996 by the consolidation of two Pennsylvania licensees of the Blue Cross and Blue Shield Association — Pennsylvania Blue Shield (now Highmark Blue Shield) and Blue Cross of Western Pennsylvania (now Highmark Blue Cross Blue Shield). We are now one of the largest health insurers in the United States.

Highmark's officers and board of directors set the company's strategic direction and corporate policies. They are guided by our mission, vision and values.

Skills

  • Acute Careunmatched
  • Benchmarkingunmatched
  • Capacity and Performance Managementunmatched
  • Communication Skillsunmatched
  • Community and Social Servicesunmatched
  • Computer Securityunmatched
  • Contract Managementunmatched
  • Contract Negotiationunmatched
  • Corporate Policiesunmatched
  • Cost Controlunmatched
  • Customer Experienceunmatched
  • English Languageunmatched
  • Facebookunmatched
  • Federal Laws and Regulationsunmatched
  • HIPAA (Health Insurance Portability and Accountability Act)unmatched
  • Health Insuranceunmatched
  • Healthcare Administrationunmatched
  • Healthcare Providersunmatched
  • Healthcare Reimbursementunmatched
  • Home Careunmatched
  • Information/Data Security (InfoSec)unmatched
  • Internet Securityunmatched
  • Leadershipunmatched
  • Legal Standardsunmatched
  • LinkedInunmatched
  • Long-Term Careunmatched
  • Managed Careunmatched
  • Management Strategyunmatched
  • Market Segmentationunmatched
  • Market Shareunmatched
  • Medical Productsunmatched
  • Medical Salesunmatched
  • Negotiation Skillsunmatched
  • Network Administration/Managementunmatched
  • Network Programmingunmatched
  • Nursing Homeunmatched
  • Patient Careunmatched
  • People Managementunmatched
  • Presentation/Verbal Skillsunmatched
  • Problem Solving Skillsunmatched
  • Provider Contractingunmatched
  • Regulationsunmatched
  • Regulatory Complianceunmatched
  • Reimbursementunmatched
  • Relationship Managementunmatched
  • Salesunmatched
  • Security Policyunmatched
  • State Laws and Regulationsunmatched
  • Team Playerunmatched
  • Willing to Travelunmatched
  • Writing Skillsunmatched
  • YouTubeunmatched

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