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CareAllies · 1 day ago

Network Management Manager - Provider Performance - Pennsylvania

Philadelphia, PA

Full-time

Hybrid

Senior Level

$91K/yr - $164K/yr

5+ years exp

CareAllies is dedicated to empowering employees and fostering growth. The Network Management Manager will oversee provider performance strategies, manage a team, and ensure effective provider relationships and education within the healthcare network.

Health CareInformation Technology

No H1B

Responsibilities

Managing daily activities and implementation of strategies for provider HEDIS and STARS performance

Recruitment and contracting of physicians, physician groups and facilities including large or complex groups/facilities

Develop and maintain relationships with providers

Ensure strategic coverage for assigned territory

Responsible for education of providers

Ongoing provider service

Lead a team of Network Operations Coordinators

Guide and educate the team to deliver the needed support services for our clients

Management, mentoring and training of a team responsible for provider contracting and provider support resources

Providing subject matter expertise to improve efficiencies and results

Ability and willingness to travel within assigned areas of responsibility

Qualification

Provider contracting experienceLeadership skillsNegotiation skillsAnalytical skillsHEDISCMS STARs experienceProject management skillsPC proficiencyMarketplaceRelationship building skillsVerbal communication skillsWritten communication skills

Required

Bachelor Degree and 5 years provider contracting experience OR 9 years managed care experience including 5 years provider contracting experience

Extensive knowledge of provider and facility contracting, products, and claims/processing systems

Leadership skills to oversee staff, implement initiatives, and work across the company to resolve issues

Negotiation skills

Relationship building skills

Knowledge of marketplace

Meet deadlines and work well under pressure

Verbal and written communication skills to interact with all levels of corporate personnel and providers

PC proficiency to include Microsoft Office

Analytical skills

Project management skills to lead or participate in projects or initiatives

Ability and willingness to travel within assigned areas of responsibility, including overnight stays

Preferred

Previous HEDIS and/or CMS STARs experience

Solid understanding of health insurance, customer messaging/design and project management

Expert level of Excel preferred (knowledge of pivot tables, VLOOKUP, etc.)

Experience in financial/trend analysis

Team player with proven ability to foster and manage working relationships within a matrix environment to obtain buy-in and drive results

Benefits

Health and wellness benefits

401(k) savings plan

Pension plan

A minimum of 15 days’ of paid time off

Paid parental leave

Disability insurance

Supplemental life insurance

Employee assistance program

Paid holidays

Tuition reimbursement

Other incentives

Company

CareAllies

CareAllies works side-by-side with health care providers to help improve the quality, value and experience of care for their patients, to make health care better for everyone.

Founded in 2016

Bloomfield, Connecticut, USA

501-1000 employees