Manager Network Management; Healthcare Job Austin Texas USA,Management

Position: Manager Network Management (Healthcare)

Job Summary

HCSC is looking for a dynamic individual to join its Provider Network management team! This position is responsible managing daily activities and implementation of strategies for provider recruitment and contracting of physicians, physician groups and facilities including large or complex groups/facilities (large independent hospital systems, integrated & non-integrated systems, value based contracting, etc.). Will develop and negotiate contracts; develop and maintain relationships with providers and ensure strategic coverage for assigned territory.

Role is responsible for education of providers and for ongoing provider service; will be responsible for the management, mentoring and training of a team responsible for provider contracting and provider support resources and provide subject matter expertise to improve efficiencies and results. Must have the ability and willingness to travel within assigned areas of responsibility, including overnight stays. Neither relocation nor sponsorship (either now or in the future) will be extended.

In-office visibility is required three days per week, working from home the other two days.

NOTE:

this is NOT an Information Technology or computer systems aligned role.

Job Requirements

Bachelor’s Degree and five (5) years of provider contracting experience OR 9 years’ of direct, managed care experience including five (5) years of provider contracting experience.
Extensive knowledge of provider and facility contracting, products, and claims/processing systems.
Leadership skills to oversee staff, implement initiatives, and work across the company to resolve issues.
Solid negotiation skills.
Strong relationship building skills.
Extensive knowledge of the healthcare marketplace.
Able to meet deadlines and work well under pressure.
Excellent verbal and written communication skills to interact with all levels of corporate personnel and providers.
PC proficiency to include Microsoft Office (Word, Excel, Outlook, PowerPoint).
Keen analytical skills.
Project management skills to lead or participate in projects or initiatives.
Ability and willingness to travel within assigned areas of responsibility, including overnight stays.

Preferred

Job Requirements

PMP Certification.
HCISPP (Healthcare Information Security and Privacy Practitioner).
Strong knowledge of hospital, professional physicians and ancillary.
Salesforce acumen.

Key Functions

Ensure assigned staff performs according to established standards. Assign duties, monitor results, control budget, and appraise performance and direct staff as appropriate.

Management duties include but are not limited to: hiring, performance management, pay administration, change management, talent management, and maintain knowledge of corporate, divisional and Human Resources policies, programs and systems.

Work with internal departments to ensure appropriate implementation of executed agreements.

Analyze financial reports to determine financial impact of negotiations.

Develop and negotiate agreements with providers and facilities (including large independent hospital systems, integrated & non-integrated systems, value based contracting, etc.) within assigned territory of responsibility.

Responsible for maintaining a professional relationship with key provider groups. Ensure effective liaison and rapport is developed and maintained through meetings, correspondence and telephone calls.

Ensure strategic objectives are being met with regard to physicians, physician groups and facilities needed for assigned territory(s). Ensure appropriate provider services including working across departments to resolve issues. Meet/exceed service goals.

Oversee the servicing of facilities, large groups, and/or capitated entities to include assisting with eligibility and capitation issues, contracting issues, and bonus arrangements. Serves as a liaison between internal departments and the capitated entity.

Work with delegated entities to ensure that providers are loaded correctly.

Work closely with the delegation oversight department regarding the delegated entity reporting requirements to include claims delegation, utilization management delegation and credentialing…