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Provider Relations-Networking-Contracting WellCare - PR & Contracting Management Careers

Network Management - Manager Job

Full Job Title: Manager, Network Management*

Job Number: 1702580

Locations:
Chicago, IL
Belleville, IL
Waukegan, IL
Springfield, IL
Moline, IL

Date Posted: 10-2-2017

Manages IPA networks and Network Development Specialists by developing and maintaining network of risk-bearing IPAs. Achieves company targets through aggressive IPA primary care, specialty and ancillary provider contracting and risk contract management. Calibrates network for the achievement of profitable growth.
Essential Functions:
  • Manages IPA networks and Network Development Specialists by developing and maintaining network of risk-bearing IPAs.
  • Achieves company targets through aggressive IPA primary care, specialty and ancillary 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.
  • Works closely with the Network Development staff regarding 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.
  • Performs other duties as assigned or directed.
Candidate Education:
  • Bachelor's Degree preferred or equivalent directly related experience.
Candidate Experience:
  • 5 years of relevant work experience in the healthcare sector, (preferably at HMO or PPO).
  • 3 years experience in HMO provider/hospital/ancillary contracting and network development.
  • 3 years progressively responsible managerial experience.

Candidate Skills:

  • Advanced - Ability to speak publicly.
  • Advanced - Demonstrated written communication skills.
  • Advanced - Demonstrated negotiation skills.
  • Advanced - Knowledge of healthcare delivery.
  • Advanced - Demonstrated customer service skills.
  • Advanced - Ability to represent the company with external constituents.
  • Advanced - Demonstrated interpersonal/verbal communication skills.
  • Advanced - Leadership skills.
  • Intermediate - Ability to multi-task.
  • Intermediate - Ability to analyze and interpret financial data in order to coordinate the preparation of financial records.
  • Intermediate - Ability to explain complicated financial terms and utilization data to physicians and staff.
  • Intermediate - Ability to analyze data to identify trends, and variance from goals.
  • Intermediate - Ability to work independently.
  • Intermediate - Ability to work within tight timeframes and meet strict deadlines.
  • Intermediate - Demonstrated analytical skills.
  • Intermediate - Demonstrated organizational and time management skills.
Technical Skills:
  • Intermediate proficiency in Microsoft Outlook, Word, and Excel required.

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Last Updated On: 12/9/2015