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AmeriHealth Caritas · 2 days ago

Corporate Provider Network Management Network Development Manager

United States

Full-time

Remote

Mid, Senior Level

4+ years exp

AmeriHealth Caritas is a mission-driven organization dedicated to delivering comprehensive health care solutions. They are seeking a Corporate Provider Network Management Network Development Manager to build and maintain provider networks, ensuring compliance with state and CMS requirements while leading network development projects and collaborating with leadership on strategic initiatives.

Health CareInformation Technology

H1B Sponsor Likely

Responsibilities

Provide project management oversight of new business implementations and market expansions, including set up and maintenance of project sites, folders, and repositories (MS Teams, SharePoint or shared drives)

Develop and maintain performance metrics, project status reports and dashboards

Complete CMS Exchange annual provider network filings for assigned growth or expansion markets

Suggest innovative operational improvements to reduce backlogs and optimize resource utilization

Serve as interdepartmental liaison:

Coordinate with Communications on tracking document development

Partner with Legal on new market contracts and timelines

Coordinate with Corporate Provider Network Operations on provider data discrepancies

Work with Payment Integrity on contract payment methodologies

Develop and maintain Standard Operating Procedures (SOPs) for CPNM processes

Manage special projects as assigned

Provides market intelligence on provider networks in new markets

Develop provider contracting strategies under the direction of the Director, Corporate Provider Network Development

Identify, recruit and negotiate contracts with hospitals, physicians and ancillary providers

Maintain communication and timely follow-up with prospective providers until contracts are finalized

Submit accurate and complete provider application packages for timely credentialing

Support team members in the identification and creative problem resolution for the improvement of processes and expanded use of technology

Document issues impacting provider recruiting efforts

Provides guidance and support to the Corporate Provider Network Management Account Executives

Stays current on RFP, CMS Filing, and application requirements

Maintains accurate records of provider contracts

Support process improvement and technology adoption initiatives

Assist with new staff orientation and training as needed

Qualification

Managed Care contractingPerformance metricsProject managementMS 365Advanced ExcelTableauSalesforceLeadershipCritical thinkingIndependent work

Required

Associate's Degree required

1 to 3 years People Manager experience

3 to 5 years Managed Care contracting experience

Experience with matrixed environment

Proficiency with MS 365; advanced Excel skills required

Strong critical thinking, leadership and independent work capabilities

Preferred

Bachelor's Degree preferred

Experience with Tableau and Salesforce a plus

Benefits

Flexible work solutions including remote options

Hybrid work schedules

Competitive pay

Paid time off including holidays and volunteer events

Health insurance coverage for you and your dependents on Day 1

401(k)

Tuition reimbursement

Company

AmeriHealth Caritas

Glassdoor3.4

AmeriHealth Caritas is the health care solutions provider for those in most need and the chronically ill.

Founded in 1982

Philadelphia, Pennsylvania, USA

10001+ employees

http://www.amerihealthcaritas.com

H1B Sponsorship

AmeriHealth Caritas has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (18)

2024 (17)

2023 (12)

2022 (14)

2021 (4)

2020 (11)