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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.
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.
Bachelor's Degree preferred or equivalent directly related 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.
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.
Intermediate proficiency in Microsoft Outlook, Word, and Excel required.