Strategic Provider Partnerships Director

Job description

Your Future is our Future At Lumeris, we believe that our greatest achievements are made possible by the talent and commitment of our team members. That's why we are actively seeking talented and collaborative individuals who are passionate about making a difference in the healthcare industry. Join us today as we strive to create a system of care that every doctor wants for their own family and become part of a community that values its people and empowers you to make an impact. We're excited to consider every qualified candidate authorized to work in the United States, although we are unable to sponsor visas for this role at this time. Position: Strategic Provider Partnerships Director Position Summary: The Strategic Provider Partnership Director is a senior, strategic individual contributor role within the strategic growth initiative, reporting directly to the SVP, Growth. This highly autonomous leader is accountable for the end-to-end identification, prospecting, cultivation, and qualification of high-value provider and health system partnerships. The role will support selective market growth only where Essence Healthcare can establish the right strategic anchor partnerships and a compelling foundation for long-term success. The role requires a seasoned healthcare strategist and relationship architect who can develop, refine, and compellingly communicate Essence Healthcare’s differentiated value proposition to health systems and large physician groups. This leader must possess the C-suite presence and healthcare expertise to connect Essence’s capabilities, clinical model, and partnership approach to the strategic priorities of prospective partners, while collaborating with internal subject-matter experts on value-based care arrangements, risk-sharing agreements, and other partnership structures. Working closely with the Network and Product organizations, this leader will translate market data, provider insights, and organizational capabilities into a strategic partnership plan. Success in this role establishes the structural and relational foundation for selective market entry and membership growth in alignment with Essence Healthcare’s strategic growth plan. Job Description: Primary Responsibilities: Strategic Prospecting & Relationship Cultivation Identify, research, and prioritize high-value provider organizations and health systems in target markets, focusing on opportunities where the right strategic anchor partnerships can support a differentiated and sustainable growth strategy. Design and execute sophisticated outreach strategies to secure access and build trust with C-suite and executive leaders at prospective partner organizations, including Health System CEOs, CFOs, CMOs, VPs of Managed Care, and Large Physician Group Executives. Serve as the primary brand ambassador and external representative of Essence Healthcare in new markets, articulating the plan's unique value proposition and clinical models. Cultivate deep, trust-based relationships within the regional healthcare ecosystem to position Essence Healthcare as the preferred Medicare Advantage partner. Deal Structuring & Business Case Development Conduct comprehensive market analyses to evaluate competitive dynamics, provider readiness for value-based care, strategic fit, and financial viability, with particular emphasis on identifying potential anchor partners. Partner closely with the Network and Product organizations to translate market data, provider insights, and product capabilities into a strategic plan for targeting health systems and other key provider organizations; collaborate with Finance, Actuarial, Legal, and Marketing to assess and support risk-sharing, value-based care, and joint-venture opportunities. Develop and present comprehensive business cases and differentiated strategic value propositions to external provider C-suite leadership teams, while facilitating substantive strategic discussions between the respective C-suite leaders of Essence Healthcare and prospective partner organizations. Own end-to-end relationship management for prospective strategic partners—from initial engagement and executive alignment through opportunity development, internal coordination, and transition—ensuring continuity, trust, and clear communication throughout the partnership lifecycle. Pipeline Management & Cross-Functional Collaboration Maintain and manage a highly organized pipeline of prospective strategic partnerships, providing regular updates and milestone reports to the SVP, Growth, and other executive stakeholders. Act as the lead coordinator across Growth, Network, Product, Finance, and Operations to align data, insights, capabilities, and resources around strategic partnership priorities and selective market-entry decisions. Identify opportunities that require executive sponsorship and facilitate strategic conversations with Essence Healthcare’s senior leadership team to align priorities, resolve key issues, and advance high-value partnerships. Continuously gather market intelligence and competitor trends to refine Essence Healthcare’s strategic partnership approach, selective market-entry criteria, and product positioning. Cross-Functional Deal Execution Stay actively engaged across Growth, Network, Product, Finance, Legal, Contracting, and Operations from opportunity development through deal execution to ensure seamless relationship management for the network partner, clear communication, timely issue resolution, and a consistent partner experience. Maintain strategic oversight and relationship continuity throughout diligence, contracting, and final execution, facilitating collaboration among internal teams, partner stakeholders, and executive sponsors to advance the agreement successfully. Qualifications Master’s in Public Health (MPH), Business Administration (MBA), or Healthcare Administration (MHA) preferred; Bachelor’s degree in a related field required. 12+ years of progressive experience in healthcare business development, network development, strategic sales, or managed care contracting. 5+ years of experience in high-level strategic business development, complex enterprise sales, or negotiating value-based care partnerships. A robust, pre-existing professional network of provider and health system contacts within Essence Healthcare's key markets (IL, KY, AR, or MO). Solid understanding of Medicare Advantage and health system economics, including managed care dynamics, value-based care structures, CMS risk adjustment, provider reimbursement methodologies, health system financial drivers, and the economic considerations that shape strategic partnerships. Proven track record of successfully engaging, presenting to, and influencing senior healthcare executives (CEOs, CFOs, CMOs). Demonstrated ability to independently navigate and close complex joint-venture agreements, Letters of Intent (LOIs), and strategic partner alignments. Highly motivated self-starter who uses data and strategic judgment to identify and prioritize target markets, then identify and pursue strategic provider and health system partnerships within those markets based on competitive dynamics, existing payer networks, market economics, and alignment with Essence Healthcare’s differentiated value proposition. Expert ability to synthesize market research, provider performance metrics, competitive intelligence, payer network composition, and other relevant data to evaluate market attractiveness, assess partnership fit, and develop compelling financial and clinical business cases. Ability to travel up to 50% for consistent, high-impact in-market C-suite presence and strategic meetings. Working Conditions While performing the duties of this job, the employee works in normal office working conditions. Pay Transparency: Factors that may be used to determine your actual pay rate include your specific skills, experience, qualifications, location, and comparison to other employees already in this role. In addition to the base salary, certain roles may qualify for a performance-based incentive and/or equity, with eligibility depending on the position. These rewards are based on a combination of company performance and individual achievements. The hiring range for this position is: $113,800.00-$154,525.00 Benefits of working at Lumeris Medical, Vision and Dental Plans Tax-Advantage Savings Accounts (FSA & HSA) Life Insurance and Disability Insurance Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days) Employee Assistance Program 401k with company match Employee Resource Groups Employee Discount Program Learning and Development Opportunities And much more... Be part of a team that is changing healthcare! Member Facing Position: No- Not Member or Patient Facing Position Drug Screen Requirement: No MVR Required: No Credit Check Required: No Location: Virtual – Microsoft Teams Time Type: Full time Lumeris and its partners are committed to protecting our high-risk members & prospects when conducting business in-person. All personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine. If this role has been identified as member-facing, proof of vaccination will be required as a condition of employment. Disclaimer: The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individual with disabilities to perform the essential job duties and responsibilities. Lumeris is an EEO/AA employer M/F/V/D.