Mgr II Provider Ntwk Mgt/Relations - Nashville, TN (96031)
Company Name:
WellPoint-Caremore
Mgr II Provider Ntwk Mgt/Relations - Nashville, TN (96031)
TN , Nashville
Job Post Date:
10/23/2014
Employer:
WellPoint, Inc
Benefits:
WellPoint's Benefits
Job Description
Amerigroup, a proud member of theWellPointfamily of companies, is focused on serving Medicaid, Medicare and uninsured individuals and families. We improve access to quality health care for the financially vulnerable, seniors and people with disabilities.
Here, you can do work that matters and offers opportunities for personal and professional growth. Together, our associates are transforming health care with trusted and caring solutions.
Location:Nashville, TN
The Manager ll Provider Network Management Relationsis responsible for doing all, or some, of the following for a region within Government Services Division. Manages hospital, ancillary, physician, behavioral health, and vendor contracting functions. Develops, implements and maintains the health plan provider network. Develops and expands health plan provider network, addresses network deficiencies, resolves provider complaints and ensures satisfaction, and coordinates contracting and management of health plan vendor relationships. Manages the servicing and contracting of providers with standard contracts. Primary duties may include, but are not limited to:
Coordinates provider network related activities in conjunction with the appropriate home office and local health plan staff.
Develops and implements provider agreements.
Negotiates contracts with providers statewide.
In conjunction with leadership, develops strategy to develop the provider network for the health plan.
Manages provider relations issue resolution, education/orientation, evaluation of network adequacy, recruitment and marketing related to providers.
Hires, trains, coaches, counsels, and evaluations the performance of direct reports.
Job Qualifications
Requires:
BA/BS degree; 7 years experience in managed care contracting and/or network management; 3 years management experience; or any combination of education/experience which would provide an equivalent background.
1 - 3 years Medicaid/Medicare experience highly preferred
WellPoint is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine, and is a 2013 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us . EOE. M/F/Disability/Veteran.
Once an offer is accepted, all external applicants are subject to a background investigation and if appropriate, drug testing. Offers of employment shall be contingent upon passing both the background investigation and drug testing (if required).
Current WellPoint associates: All referrals must be submitted through the formal associate referral process on WorkNet. Official guidelines for the associate referral program can be found in My HR.
WARNING : Please beware of phishing scams that promote work-at-home opportunities and may also pose as legitimate companies. Please be advised that a WellPoint recruiter will never ask you for a credit card or any type of payment as part of consideration for a role with our company. All of our careers require that you first complete an online application on our web site.Estimated Salary: $20 to $28 per hour based on qualifications.
WellPoint-Caremore
Mgr II Provider Ntwk Mgt/Relations - Nashville, TN (96031)
TN , Nashville
Job Post Date:
10/23/2014
Employer:
WellPoint, Inc
Benefits:
WellPoint's Benefits
Job Description
Amerigroup, a proud member of theWellPointfamily of companies, is focused on serving Medicaid, Medicare and uninsured individuals and families. We improve access to quality health care for the financially vulnerable, seniors and people with disabilities.
Here, you can do work that matters and offers opportunities for personal and professional growth. Together, our associates are transforming health care with trusted and caring solutions.
Location:Nashville, TN
The Manager ll Provider Network Management Relationsis responsible for doing all, or some, of the following for a region within Government Services Division. Manages hospital, ancillary, physician, behavioral health, and vendor contracting functions. Develops, implements and maintains the health plan provider network. Develops and expands health plan provider network, addresses network deficiencies, resolves provider complaints and ensures satisfaction, and coordinates contracting and management of health plan vendor relationships. Manages the servicing and contracting of providers with standard contracts. Primary duties may include, but are not limited to:
Coordinates provider network related activities in conjunction with the appropriate home office and local health plan staff.
Develops and implements provider agreements.
Negotiates contracts with providers statewide.
In conjunction with leadership, develops strategy to develop the provider network for the health plan.
Manages provider relations issue resolution, education/orientation, evaluation of network adequacy, recruitment and marketing related to providers.
Hires, trains, coaches, counsels, and evaluations the performance of direct reports.
Job Qualifications
Requires:
BA/BS degree; 7 years experience in managed care contracting and/or network management; 3 years management experience; or any combination of education/experience which would provide an equivalent background.
1 - 3 years Medicaid/Medicare experience highly preferred
WellPoint is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine, and is a 2013 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us . EOE. M/F/Disability/Veteran.
Once an offer is accepted, all external applicants are subject to a background investigation and if appropriate, drug testing. Offers of employment shall be contingent upon passing both the background investigation and drug testing (if required).
Current WellPoint associates: All referrals must be submitted through the formal associate referral process on WorkNet. Official guidelines for the associate referral program can be found in My HR.
WARNING : Please beware of phishing scams that promote work-at-home opportunities and may also pose as legitimate companies. Please be advised that a WellPoint recruiter will never ask you for a credit card or any type of payment as part of consideration for a role with our company. All of our careers require that you first complete an online application on our web site.Estimated Salary: $20 to $28 per hour based on qualifications.
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