Health Partner Network Manager

This is a fully remote position, open to applicants in United States.

📋 Description

• Implement the contracting strategy for Health Partners within the designated market.

• Develop contractual terms based on cost and quality assessments, while monitoring essential metrics.

• Design, execute, and manage value-based reimbursement methods.

• Conduct annual reviews of contracting strategies for effectiveness and ensure adherence to corporate compliance.

• Recruit providers, negotiate agreements, and initiate the loading and credentialing processes.

• Monitor and audit providers during the loading phase.

• Draft contract language and collaborate with legal to create approved templates specific to the market.

• Analyze financial information and determine rates in conjunction with Provider Contracting leadership and Finance.

• Negotiate and renegotiate contracts, terms, and reimbursement rates for hospitals, ancillary services, physicians, and behavioral health.

• Establish networks for new products and onboard additional providers.

• Ensure compliance with regulatory obligations and conduct gap analyses.

• Identify providers for recruitment, implement risk-mitigation strategies, and formulate corrective action plans.

• Engage in training sessions for providers and staff.

• Assist with the contracting needs for various geographic areas and products.

• Provide support for payment policies and notifications to providers.

• Act as a subject matter expert on specific provider types when required.

• Mentor junior contractors upon request.

• Carry out other duties as assigned.

⛳️ Requirements

• A Bachelor’s degree in a healthcare-related field or equivalent relevant work experience is mandatory.

• A Master’s Degree is preferred.

• A minimum of three (3) years of experience in healthcare, including at least one (1) year in managed care provider relations or provider contracting.

• Experience in managed care is strongly preferred.

• Intermediate skills in Microsoft Outlook, Word, and Excel are required.

• Familiarity with Provider Network Management Processes & Services.

• Excellent negotiation abilities.

• Strong oral and written communication skills.

• Proficient critical listening and analytical thinking skills.

• Skills in training and teaching.

• Effective time management capabilities.

• Must possess a valid driver’s license, a vehicle, and verifiable insurance.

• Successful completion of a driver’s license record check and verification of insurance is necessary.

• An influenza vaccination is required for this position.

• Willingness to travel up to 30% is essential.

🏝️ Benefits

• Bonus linked to both company and individual performance.

• A robust and comprehensive total rewards package.

• Reasonable accommodations available for qualified individuals.

• Influenza vaccination provided/required as a condition of continued employment.