Network Development Manager-Pensacola Job in Pensacola 32501, Florida Us
Manages IPA networks and network development by building and maintaining network of risk-bearing IPAs. Achieves company targets through aggressive IPA primary care and specialty provider contracting and risk contract management. Calibrates network for the achievement of profitable growth.
Essential Functions:
- Achieves company targets through aggressive IPA primary care and specialty provider contracting and risk contract management
- Identifies potential new IPA relationships for profitable growth
- Monitors primary care and specialty risk arrangements for Medicaid and Medicare product lines
- Responsible for contracting and contract management inquiries
- Assists in the analysis of claims trend data and/or market information to derive conclusions to support positive risk arrangements
- Drives RAPS initiative to maximize revenue
- Other duties as assigned or directed
Education: Bachelor's degree preferred or equivalent directly related experience
Experience: 5 + years of work experience in the healthcare sector (preferably with HMO or PPO). 3+ years experience in HMO provider/hospital/ancillary contracting and network development.
Special Skills (e.g. 2nd language): Excellent influencing and negotiating skills. Ability to explain complicated financial terms and utilization data to physicians and staff. Excellent written skills and the ability to speak publicly are essential. Must be organized and have excellent time management capabilities. Ability to analyze data in Excel to identify trends, and variance from goals. Strong leadership ability.
Overtime: Varies
Additional Information:
- Travel Percentage: 50%
