Network Director - Louisiana Resident

Magellan Health • Shreveport, LA

4d • Remote

About The Position

Responsible for the strategic and tactical direction of all activities for an assigned region(s) related to developing and maintaining the physician, practitioner, facility and organization services delivery system. Position is responsible for developing and implementing a plan that meets the customer requirements within budget. Assures access to a network of services that supports member access and that the Care Management Centers (CMCs) are within cost of care plans. Establishes overall direction and plan and working processes between Network Management and Network Administration staff, including credentialing, communication (provider services line, letters, website, etc), database integrity and maintenance, regular reports, and rate loading. Develops and implements a Network strategy to assure long term mutually successful physician, practitioner and facility and organization provider relationships. Directs all provider (physician, practitioner and organizations) recruitment activities. Provides supervision, development and mentoring of the Field Network Management Department in meeting objectives and functions. Manages financial goals (e.g., control care cost trends, profitability) as defined by the business operations, network and CMC senior management team, including assuring that the network is cost effective, marketable, stable and offers appropriate access and CMCs meet cost of care plan. Directs network reimbursement and negotiation strategies in conjunction with business operating unit senior management team to assure CMC is within cost of care plan. Establishes programs to develop and maintain positive relationships between MBH and providers, and to influence and change behavior of providers in accordance with business operations goals and objectives. The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description.

Requirements

• Louisiana resident
• 8+ years of progressively more responsible health care administration experience (finance/contract administration, physician/provider relations)
• 3 years experience in a leadership role
• Broad-scoped financial expertise, with financial modeling experience

Nice To Haves

• Strong preference for managed care experience

Responsibilities

• Develop and implement a plan that meets customer requirements within budget.
• Assure access to a network of services that supports member access and that CMCs are within cost of care plans.
• Establish overall direction and working processes between Network Management and Network Administration staff.
• Develop and implement a Network strategy to assure long term mutually successful provider relationships.
• Direct all provider recruitment activities.
• Provide supervision, development and mentoring of the Field Network Management Department.
• Manage financial goals, including assuring the network is cost effective, marketable, stable and offers appropriate access.
• Direct network reimbursement and negotiation strategies.
• Establish programs to develop and maintain positive relationships between MBH and providers.
• Influence and change provider behavior in accordance with business operations goals and objectives.

Benefits

• Short-term incentives
• Comprehensive benefits package
• Broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager