Job Title: Provider, Network Manager
- You are expected to work directly and give direct support services to your business unit as it relates to all assignments you may be given.
- Design and implement programs that help us build and nurture positive relationships between the health plan, providers and practice managers
- Implement strategies for the development of provider networks, identify gaps in network composition and services, and assist the network staff to prioritize contracting needs.
- Develop the provider network (physicians, hospitals, pharmacies, ancillary groups & facilities, etc.)
- Yield a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners.
- Evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls
- Establish and maintain strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensuring the network composition includes an appropriate distribution of provider specialties.
- Manages the development of a healthcare network.
- Oversees the negotiation of managed care or other payer contracts
- Responsible for daily activities, provider relations, and credentialing
- Anticipate customer needs and proactively develop solutions to meet them.
- Entrepreneurial and Numerical Competence
- Business Consulting and Development
- Competency Management
- Complaint & Conflict Management (Emergency/ Crisis Management)
- Customer Focus
- Information Management
- Learning and Self Development
- First Degree in Humanities, Master’s degree in business, health care management or related field
- Minimum of 7 Years’ Experience, with 5 Years’ Experience in a Network Management Role.
- Strong negotiation skills and experience
- Excellent problem solving skills, including the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action
- Excellent verbal and written communication and relationship skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
- Ability to develop and manage network strategies in a start-up environment
- Knowledge and experience in deployment of various reimbursement and risk-based methodologies
- Ability to utilize financial modeling and analysis in decision making
- In-depth knowledge of the network strategy and contracting process
- Must be Friendly, honest, transparent and diligent in all dealings.
Application Closing Date
7th February, 2017.
Method of Application
Interested and qualified candidates should send their CV’s to: firstname.lastname@example.org