Provider Network Manager
About The Position
A bit about this role: This is a key in our organization. The role will be responsible for network development and management along with servicing for an assigned geographic area. The ideal candidate will possess 5+ years experience in recruiting and managing provider networks along with negotiating, reviewing and amending contracts. This experience will include thorough knowledge of contracting with physicians and physician groups, integrated delivery systems, health systems, and ancillary providers using various payment methodologies including fee-for-service and value based / risk. Ideally, the candidate will possess a very high level of business acumen and be able to exhibit it both internally and externally to a wide variety of audiences. Innovation, independence and confidence are key competencies that need to be exhibited.
Requirements
- 5+ years negotiating provider contracts including physician / provider group contracts with multiple payment methodologies including value based/risk
- Provider servicing experience
- Solid ability to navigate either Google or MS Suite of products
- High School Diploma or equivalent minimum
- Experience in CMS STAR measures
- Experience and relationships in the local market
- Unrestricted driver's license to verify your eligibility and capability to fulfill the driving responsibilities associated with the position
Responsibilities
- Development, maintenance and management of an adequate provider network in assigned geographical area
- Maintaining relationships and all provider relations activities in assigned geographical area
- Negotiating and renegotiating contracts with providers as assigned
- Engage internal subject matter experts and providers to identify opportunities to improve provider / member cost and quality performance
- Monitoring of various reports to insure all necessary compliance requirements are met and maintained
- Reporting to leadership current status, risks, and potential opportunities in area of responsibility on a regular basis
- Supporting the overall Network Team as required to achieve success for Devoted Health
- Supporting assigned groups to improve performance in CMS STAR measures
Benefits
- Employer sponsored health, dental and vision plan with low or no premium
- Generous paid time off
- $100 monthly mobile or internet stipend
- Stock options for all employees
- Bonus eligibility for all roles excluding Director and above
- Commission eligibility for Sales roles
- Parental leave program
- 401K program
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
