Mgr, Network Management in Bellevue, WA

$150K - $200K(Ladders Estimates)

WellCare Health Plans, Inc   •  

Bellevue, WA 98004

Industry: Healthcare


5 - 7 years

Posted 54 days ago

WellCare is seeking a successful Manager, Network Management to join our new team in the Seattle, WA area! We are extremely excited about our entrance into the local healthcare market and working with ourhigh-profile partners in the area. This is a fantastic opportunity to become a true conduit in all areas forour providers. In this role you will build relationships with our current network partners as well as help toidentify new valuable network partners. At WellCare, our Network team is considered the 'right-hand' ofour Providers and internal teams. We empower you to manage the relationship and provide the resources to be successful This full-time, direct hire position will be based at our new office location in Bellevue, WA. This position offers a competitive salary, growth potential and is bonus eligible. WellCare offers a robust benefits package including over 3 weeks of paid time off, 8 holidays and 2 floating holidays and much more! We strongly desire local candidates who will share our 'One Team' philosophy to apply!!

Key Words: Provider Relations, Contracting Specialists

Manages physician contracting and network development for an assigned region. Responsible for developing, executing and maintaining a provider network strategy. Continuously evaluates network toensure cost effective, optimal functionality. Works in concert with medical management and sales developing actions to meet market growth and medical cost targets.

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 risk contract 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 financial risk.
  • 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:

Valid Through: 2019-10-17