Provider Network Manager

EWINGS is seeking a Provider Network Manager to join an emerging health plan dedicated to providing a comprehensive, integrated healthcare solution that offers the high-quality care anyone would want for their loved ones. Candidates must be located in or have specific expertise contracting healthcare providers in Kentucky . EWINGS is the leader in helping clients build large-scale healthcare provider networks. Many of our projects have required teams of 100-200+ network consultants. Since 2002 we've developed provider networks for our clients in over 3,000 cities and all 50 states. Our network recruiters are responsible for leveraging client provided data to contact providers, build relationships, negotiate contracts, and manage various elements of the contracting process. It is an exciting time to be a EWINGS consultant! A network assignment with EWINGS provides you an opportunity to quickly gain valuable experience developing networks in multiple states for a variety of products with organizations of various sizes. New projects are starting all the time, so now is your chance to introduce yourself to our organization and join our roster of exceptional talent. Opportunity Snapshot: The role will be responsible for network development and management along with servicing for an assigned geographic area. The ideal candidate will possess 5+ years experience in recruiting and managing provider networks along with negotiating, reviewing and amending contracts. This experience will include thorough knowledge of contracting with physicians and physician groups, integrated delivery systems, health systems, and ancillary providers using various payment methodologies including fee-for-service and value based / risk. Ideally, the candidate will possess a very high level of business acumen and be able to exhibit it both internally and externally to a wide variety of audiences. Innovation, independence and confidence are key competencies that need to be exhibited. Responsibilities: Develop, maintain, and manage an adequate provider network in the assigned geographical area Maintain relationships and conduct all provider relations activities in the assigned geographical area Negotiate and renegotiate contracts with assigned providers Engage internal subject matter experts and providers to identify opportunities for improving provider and member cost and quality performance Monitor various reports to ensure compliance requirements are met and regularly report the current status, risks, and potential opportunities in the area of responsibility to leadership Support the overall Network Team as needed to achieve success for the health plan Support assigned groups to improve performance in CMS STAR measures Required skills and experience: 5+ years negotiating provider contracts including physician / provider group contracts with multiple payment methodologies including value based/risk Provider servicing experience Solid ability to navigate either Google or MS Suite of products Experience in CMS STAR measures Experience and relationships in the local market Unrestricted driver's license to verify your eligibility and capability to fulfill the driving responsibilities associated with the position Ability to make quick, independent decisions Mutually beneficial negotiation skills Strong project management skills Attention to detail Ability to analyze financial and performance reports and identify trends/variances "Big Picture" thinking...Understanding impacts of decisions on network as a whole Extremely effective oral/written communication skills Benefits: Employer sponsored health, dental and vision plan with low or no premium Generous paid time off $100 monthly mobile or internet stipend Stock options for all employees Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles Parental leave program 401K program And more....

Created: 2024-11-02