Provider Network Manager I/II
Bcidaho

Job Info

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Develop and maintain positive working relationships with contracted providers. Actively audit and monitor financial performance of all assigned providers to ensure network sustainability. Analyze, review, and project financial impact of contract arrangements. Initiate and maintain effective communication channels with internal business partners. Ensure accurate implementation and administration of contracts.

We are looking for a Provider Network Manager with:

Provider Network Manager I:

• 4 years' provider contract/network management, provider reimbursement methodologies, contracting, negotiation, or relevant experience
  Education: Bachelor's Degree or equivalent work experience (Two years' relevant work experience is equivalent to one-year college)

Provider Network Manager II:

• Experience: 6 years' provider contract/network management, provider reimbursement methodologies, contracting, negotiation, or relevant experience

Required Education for both levels:

• Bachelor's degree or equivalent work experience (Two years' work experience is equivalent to one year of college)

What a day of a Provider Network Manager may look like:

• Guide and coach staff in contract negotiation processes.
• Manage relationships with providers and internal business partners.
• Develop and maintain a cost-effective network of contracted providers.
• Train and mentor contracting staff in the management and implementation of contracts and the performance of these agreements.
• Ensure effective workflows and maximize system efficiencies. Make recommendations for changes.
• Lead complex contract implementation projects.
• Create innovative payment methodologies for self-funded employer groups that align the incentives of healthcare providers with outcomes based, cost effective healthcare.
• Identify strategic opportunities for standard and/or complex contracts to increase cost savings and monitor successful financial performance.
• Manage, formulate, analyze, coordinate, and negotiate contracts with large healthcare systems and provider networks. Manage contracting process, contract negotiations, execution, and implementation of contract and payment methodologies
• Improve provider network efficiencies through the identification of cost and quality outliers.

Reasonable Accommodations

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.

This job has expired.