Network Management Manager

Description:

• Manages contract performance and drives the development and implementation of value based contract relationships in support of business strategies.
• Recruits providers to ensure attainment of network expansion and adequacy targets.
• Accountable for cost arrangements within defined groups.
• Collaborates cross-functionally to manage provider compensation, pricing development, submission of contractual information, and the review of reports for negotiation and reimbursement modeling activities.
• Responsible for identifying and managing cost issues and executing cost-saving initiatives.
• Represents company with high visibility constituents, including customers and community groups.
• Evaluates, formulates, and implements provider network strategic plans to achieve contracting targets and manage medical costs through effective provider contracting to meet state contract and product requirements.
• Ensures resolution of escalated issues related to claims payment, contract interpretation, and accuracy of provider contract or demographic information.

Requirements:

• 3 to 5 years working experience in contract performance
• Knowledge and experience problem solving.

Benefits:

• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

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