Provider Network Manager

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Job description

EWINGS is seeking a fully remote 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 and have specific expertise contracting healthcare providers in Florida.

Qualified candidates will be contacted within 24 hours of applying!

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.

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

Hiring Process

The hiring process will consist of a pre-screening call, one interview with EWINGS, and one to two interviews with the Client team. We are looking to connect with qualified candidates immediately - apply today!

Candidates that input the information requested in the registration process will increase their chances of being contacted when a position matches their exact skills and experience.

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