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Director, Provider Strategy

Director, Provider Strategy

# Positions 
US-Home Office/ Remote
Information Technology - All Openings
Travel Requirements 

More information about this job


Under general direction, this role is primarily responsible for setting the strategic direction of NASCO’s Provider Solutions.  This includes being in tune with market place drivers for provider-based strategies as well as working strategically with our Plan customers to understand their provider, network and reimbursement based strategies and to create and execute the roadmaps to enhance the NASCO solutions that will enable our Plans’ business strategies. This role creates, manages and communicates the product strategy and roadmap for provider and reimbursement. The role brings knowledge to various NASCO departments including the Product Delivery team, the Architecture team and the Marketing team regarding Payer’s needs for provider and payment solutions, marketplace intelligence on competing solutions and a broad range of experience on various implementation & product launch techniques for rapidly bringing new features to Provider & Payment solutions.  This role communicates with the Vice President, Corporate and Product Strategy regarding product strategy & roadmap, product adoption, competitive intelligence and new opportunities for partnerships that advance NASCO’s position in the market place and with our clients.  This role also interfaces with a cross-functional team representing NASCO departments such as Technical Delivery Team(s), Professional Services and Business/Technical Architecture, as well as our Plan customers.


Essential Roles and Responsibilities:

  • Sets and owns the NASCO Provider and Reimbursement product strategy by staying on top of industry trends within the health plan payer and provider market as well as Provider Management and Reimbursement solutions.
  • Defines the capabilities of the base solution for NASCO’s provider and payment solutions, as well as identifying growth opportunities for additional capabilities, such as provider quality, provider credentialing, network modeling and shared risk contracts.
  • Creates product strategy, capability models and roadmaps for aligning Plan business to NASCO provider and payment based solutions. Provides guidance and support to Plan implementations of NASCO’s provider and payment based solutions. 
  • Develops Plan adoption and Plan migration strategies from NASCO legacy applications to NASCO’s modernized Provider Management solution.
  • Studies, evaluates and assesses market-place needs for risk-based arrangements to drive capabilities into NASCO’s Payment Engine.
  • Partners with Professional Services to provide consultation for provider operations BPO offerings.
  • Assists Business Architecture with the enablement plan for ideations within NASCO’s Provider Network and Management product line.
  • Helps define organizational strategic objectives and drives business outcomes in alignment to the strategy.
  • Performs other duties as assigned by management.

Additional Roles and Responsibilities:

  1. Leads the NASCO Provider Governance Council and Payment Engine Council.
  2. Participates in NASCO’s Governance committees as needed and requested.


Required Knowledge, Skills, Abilities and Experience:

  • Healthcare domain expertise, knowledge of provider operational process flows, background of working with provider practices or within a Payer’s provider area is a plus.
  • Strong understanding of a Plan’s provider, network, and reimbursement based strategies and how to engage Plans for identification of strategic and tactical business drivers.
  • 5 to 7 years of experience managing or consulting in payer markets for provider solutions, technologies, and operations
  • Minimum of 8 years experience in developing, support and/or implementing Provider solutions in Payer settings
  • At least 5 years experience in a leadership role managing teams and customer engagements.
  • Strong problem solving and troubleshooting skills
  • Ability to influence stakeholders to align to a common direction and manage multiple stakeholders with differing needs and requirements
  • Strong communication skills to effectively communicate strategic direction and how tactical initiatives link to strategic outcomes to senior level executives at Plans and NASCO.
  • Knowledge of Product Development Lifecycle, Software Development Lifecycle, and working in an agile delivery environment.
  • Ability to stay in tune with market trends and incorporate into product direction and strategy
  • Ability to collaborate and build effective relationships with vendors, partners, Plans, and internal stakeholders

Required Training and Education:

  • Bachelor’s degree in a related field or equivalent work experience

Working Conditions:

  • Well-lighted, heated and/or air conditioned indoor office setting with adequate ventilation
  • Must be able to sit and use equipment at workstation for up to 8 hours daily
  • Ability to travel 20% to 40%

 NASCO is a Minority/Female/Disability/Vet/Affirmative Action Employer.