Senior Manager, Provider Network Strategy

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

📋 Description

• Oversee and direct a proactive provider network strategy tailored for the Louisiana Medicaid Market.

• Ensure adherence to the standards set by the Louisiana Department of Health and NCQA for network compliance.

• Track monthly advancements in relation to the objectives outlined in the annual network development plan.

• Propose alternative strategies to meet at-risk network goals.

• Conduct market analysis to evaluate competitive positioning in the industry.

• Suggest strategies aimed at market expansion and strengthening provider partnerships.

• Establish a prioritized list of provider recruitment targets.

• Develop training materials for the department to aid in identifying suitable provider targets.

• Create a network management activity dashboard that reflects contracting productivity, project status, and escalation requests.

• Formulate and implement engagement and change strategies to enhance the adoption of processes, tools, and operational practices.

• Deliver real-time insights and recommendations to senior leadership.

• Collaborate with matrixed leaders to identify organizational challenges and propose effective solutions.

⛳️ Requirements

• A minimum of 7 years of experience in Medicaid managed care provider contracting, provider engagement, performance management, or value-based contracting.

• Comprehensive understanding of the Medicaid provider landscape and reimbursement models.

• Proven experience in engaging and partnering with both internal and external stakeholders.

• Residency in the Louisiana market is essential.

• Familiarity with the Louisiana Medicaid landscape is required.

• A solution-oriented mindset for addressing provider challenges.

• Experience in change-enablement strategies and execution.

• Proficient in business intelligence practices.

• Bachelor's degree or equivalent professional experience is necessary.

🏝️ Benefits

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources promoting physical, emotional, and financial well-being.

• CVS Health bonus, commission, or short-term incentive program.

• Equity award program.