Manager, Network Management

WellCare Health Plans, Inc   •  

Baton Rouge, LA

Industry: Healthcare


5 - 7 years

Posted 154 days ago

This job is no longer available.

Essential Functions:

  • Leads a team of Network Management Representatives and/or Specialists in developing, servicing and contracting providers.
  • Achieves company targets through aggressive IPA primary care, specialty and ancillary provider contracting and riskcontract management.
  • Monitors primary care and specialty risk arrangements for Medicaid, and Medicare product lines.
  • Performs data analysis and develops specific actions to manage medical cost trend.
  • Assists in developing practices to assist risk partners in managing financialrisk.
  • Identifies areas to improve provider service levels.
  • Educates/enhances relationships within the provider community.
  • Special projects as assigned or directed.

Additional Responsibilities: Candidate Education:

  • Required A Bachelor's Degree in a related field
  • Required or equivalent work experience in Network Development or Provider Relations

Candidate Experience:

  • Required 5 years of experience in the healthcare sector (preferably at HMO or PPO)
  • Required 4 years of experience in HMO provider/hospital/ancillary contracting and network development
  • Required 1 year of management experience
  • Required Other Or 3 years of Supervisory, or Lead/Sr. role with demonstrated leadership ability or program management experience

Candidate Skills: Licenses and Certifications:

A license in one of the following is required: