Manager, Contracting & Network Development

Centene   •  

Milwaukee, WI

Industry: Healthcare IT

  •  

5 - 7 years

Posted 394 days ago

Description

 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.

  • 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.

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