Become part of a team that's reshaping how provider networks evolve and how health care works better for millions. As a manager within our network contracting team, you'll guide the development and support of Provider Networks as well as unit cost management activities through financial and network pricing modeling, analysis, and reporting. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 6 leader.
- Manage unit cost budgets, target setting, performance reporting and associated financial models
- Guide development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management
- Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls
- Ensure that network composition includes an appropriate distribution of provider specialties
- Provide explanations and information to others on difficult issues
- Coach, provide feedback and guide others
- Develops the provider network (physicians, hospitals, pharmacies, ancillary groups & facilities, etc.) yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners
- Evaluates and negotiates contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls
- Establishes and maintains strong business relationships with Hospital, Physician or ASC providers, and ensures the network composition includes an appropriate distribution of provider specialties
- Generally, work is self-directed and not prescribed
- Works with less structured, more complex issues
- Serve as a resource to others
Get ready for some significant challenges. This is an intense, fast-paced environment that can be demanding. In addition, there are some data challenges and unique problems that need to be solved related to gaps in the process.
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
- Bachelor’s degree or equivalent years of experience
- 2 years of experience in a network management-related role, such as contracting or provider services
- Intermediate level of knowledge of claims processing systems and guidelines
- Intermediate knowledge of Microsoft Office (Word, PowerPoint, and Excel)
- Excellent leadership, communication (written and oral) and interpersonal skills
- Proven ability to work creatively and analytically in a problem-solving environment
- Master’s degree
- 2 years of experience in fee schedule development using actuarial models
- 2 years of experience using financial models and analysis to negotiate rates with providers