Health Partner Network Manager
Core
Execute health partner contracting strategy, develop contract provisions, and monitor key metrics for assigned markets.
Role type
Senior IC provider network manager
Builds
Provider networks for new products and on-boarding new providers
Domain
Healthcare / Managed Care
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
Value-based reimbursement (VBR) strategy execution, provider recruitment and credentialing, contract negotiation, financial data analysis, regulatory compliance, gap analysis and risk mitigation, payment policy development
Preferred skills
Master's degree in healthcare, managed care experience
Technologies
Microsoft Outlook, Word, Excel
Responsibilities
Create and administer VBR strategies; conduct annual effectiveness reviews of contracting strategies; recruit providers and initiate loading/credentialing processes; create and review contract language with legal; negotiate hospital, ancillary, physician, and behavioral health contracts; analyze financial data to establish rates; build networks to support new products; perform gap analysis to mitigate risk; participate in provider training sessions; mentor junior contractors
Seniority
Mid-Senior level, hands-on IC
