Develops and manages the physician/provider network. Develops programs to recruit, service, train, and reimburse physician and providers. Designs and implements programs to maintain positive relationships between the health plan, physician, providers, and practice manages.
Requires at least 50% local travel to network providers
Coverage Area Mississippi Gulf Coast and Mobile area
Car & valid driver’s license required (mileage reimbursement provided)
Responsible for assisting with the general oversight of provider network in assigned territory, to include financials, quality initiatives, provider data accuracy, trend analysis, and provider engagement (particularly PCPs and key hospital partners). Responsible for collaborating with more senior administrator on strategic plans on growth, development, and vision for assigned territory. Presents at monthly financial review with senior management.
Expected to assist in network development, physician contracting, and managing key partner relationships for assigned territory. Develops and maintains relationships with physicians, providers, and practice managers within the provider network to drive optimal performance on Stars, coding, utilization, and overall financial performance. Responsible for mentoring Network Opns Senior Analysts within their aligned territories.
MINIMUM: Bachelors degree. At least two years related experience.
Managed care contracting or IPA management experience. Masters degree. Experience in physician relations or managed care.
US Candidates Only: Qualified applicants will be considered for employment without regard to race, color, religion, national origin, sex, sexual orientation, gender identity, disability, veteran status. If you require a special accommodation, please visit our Careers website or contact us at [Apply online].