Manager, Contracting & Network Development - Healthcare

Location: Tacoma, WA
Manager, Contracting & Network Development - Healthcare
 
Joining this team means you'll be surrounded by colleagues who are dedicated to meeting their own high standards, to inspiring their teammates and to making a positive impact on under-insured and uninsured individuals. The group is a fast, agile, customer-focused organization with a commitment to implementing the latest technologies.
 
Our client serves more than 55 million managed care members through their portfolio of high-quality commercial and government sponsored healthcare programs. The broad offering of programs that they provide has helped them to build both capacity and capability to successfully navigate a changing healthcare environment, while continuing to offer better health outcomes at lower costs.
 
Position Purpose:
Provide support for the management of physician, hospital and ancillary provider recruitment in accordance with corporate, health plan and state guidelines for assigned regions.
 
Job Description:
  • Implement development activities for the recruitment and contracting of providers in provider networks in new and prospective markets
  • Promote, maintain and manage team goals and objectives through effective hiring, performance management, coaching and career development
  • Collaborate interdepartmentally for new and existing market expansions to ensure network operations deliverables are identified and completed as defined by the state Request for Proposals (RFPs) and/or state contract
  • Manage and conduct effective contract negotiations and develop strategies, tactics and methods for specific network development initiatives
  • Manage provider data management functions through a new RFP and/or state contract implementation with strategies that promote provider network
  • Monitor operational and financial performance of contracts to guide future recruitment activities and future contract negotiations
  • Develop a comprehensive provider network to meet or exceed contractual requirements
  • Contribute to the development and use of provider marketing and training materials assuring compliance with all state, federal, and product guidelines in new and existing markets
  • Contribute to the development of contract reimbursement methodologies, reimbursement allotment, and covered benefit grid to ensure contracts and fee schedules are performing optimally
  • Ability to travel
 
Qualifications:
Education/Experience:
  • Bachelor’s degree in Health Administration, Business Administration, related field, or equivalent experience.
  • 4+ years of provider recruitment, contracting, contract analysis, or provider relations experience.
  • Must be knowledgeable of network development processes, contract language, principles of negotiation, credentialing and call center operations.
 
Licenses/Certifications:
  • N/A
 
Our client offers options that allow you to do more than just plan for retirement. Their programs allow shared success with employees.
  • 401(k) with company match
  • Employee stock purchase plan
  • Training and Learning Opportunities/Tuition Reimbursement/Educational Assistance
  • On-site fitness center or discount at local fitness centers (most locations)
  • Discounts for select local and national products and services, including cell phones, computers and more
  • Other amenities may be available, but vary by location
 
Equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
 
 
 
 
April A. Estes
Senior Recruiter
720-439-2609 Direct
april@proenlist.com 
www.proenlist.com 
www.medenlist.com 

www.linkedin.com/in/aprilaestes
 
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