Manager Network Management

Magellan Health Services   •  

Roanoke, VA

Industry: Managed Care & Health Insurance


5 - 7 years

Posted 340 days ago

Manages the Magellan Provider Contract Administration functions. Ensures accurate and timely processing of all provider contracting activities in accordance with client, regulatory, and Magellan Policy and Procedures. Manages and maintains daily workflow, ensure production and quality standards are met, and ensures operational efficiencies and effectiveness. Ensures coordination between provider credentialing, contract administration and all Magellan departments, including field network with regard to interdependencies, procedure development, auditing, training and quality improvement. Provides leadership to establish a positive work environment that encourages employee participation in process improvement and commitment to department/company success

Essential Functions:
-Coordinates, establishes and maintains productivity and quality standards. Oversees network administration staff to assure production and tracking of contract and credentialing processes.
-Partners with leadership to ensure process changes are developed when necessary, training is provided, processes are implemented and results support department success.
-Manages hiring, employee turnover and training within Human Resources guidelines and requirements in a manner that results in a stable, positive and productive work environment.
-Represents Network in client meetings and committees as needed.
-Responsible for day to day network management and provider relations, including implementing processes between network management and program administration. These include credentialing/certifications, supporting provider training, identifying and gaining legal approval for contract language changes, contract signatures and execution, addition of addenda to contracts as required, interfacing with communications (provider services line, letters, website) and data management.
-Other duties as assigned by management.

Minimum Qualifications


Bachelors (Required), Masters

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements


5+ years of progressively more responsible health care administration experience with strong preference for managed care experience. A minimum of 1 year experience in a supervisory role., Capable of managing a variety of complex issues while driving momentum of key projects. Clearly and understandably articulates goals and expectations, relating them to the business mission and direction. Ability to analyze data to model contracts and fee schedules. Database management experience. Proficient use of Microsoft Office products.