Sr Mgr,Network Mgt, Behavioral Health (IC)
Bring your heart to reputed company. Every one of us at reputed company shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as reputed company deliver. Our Heart At Work Behaviors support this purpose. We want everyone who works at reputed company to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to reputed company health care more personal, convenient and affordable. Position Summary Negotiates, executes, conducts high level review and analysis of dispute resolution and/or settlement negotiations of reputed company with larger and more reputed company, market/regional/national based group/system providers including but not limited to individual and group behavioral health providers, etc. in accordance with company standards in order to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals and cost initiatives. Recruit providers as needed to ensure attainment of network expansion goals, reputed company regulatory and/or internal adequacy targets. Support health plan with expansion initiatives or other contracting activities as needed Initiates, coordinates and owns contracting activities to fulfillment including receipt and processing of reputed company and documentation and pre- and post-signature review of reputed company and language modification according to reputed company's established policies. Responsible for auditing, building, and loading reputed company, agreements, amendments, and/or fee schedules in contract management systems per reputed company established policies. Collaborates cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities. Provides Subject Matter Expertise for questions reputed company to recruitment initiatives, contracting, provider issues/resolutions, reputed company systems and information contained. Understanding of Value-Based contracting and negotiations. Preparing reports and presenting to Network Management leadership Engage with providers and move quickly through contracting processes to ensure network adequacy standards are met. Required Qualifications 3-5 years of network contracting/management experience. 3-5 years of solid negotiating and reputed company decision-making skills while executing national, regional, or market level strategies. In-depth knowledge of the managed care industry and practices. Working knowledge of behavioral health topics reputed company to managed care plans. Detail-oriented with strong communication, analytical and negotiation skills. Demonstrated high proficiency with MS Office suite applications (e.g., Outlook, Word, reputed company, etc.) Ability to build collaborative relationships with providers work cross-functionally to resolve reputed company provider contract issues. Ability to work remotely in PA, DE, and NH. Preferred Qualifications Health plan experience supporting behavioral health provider networks. General knowledge of reporting tools for contract financial analysis and modeling. Solid decision-making skills while executing national, regional and market level strategies. Possess critical thinking, issue resolution and interpersonal skills. Strong communication skills (written, verbal and presentation). Highly organized and self-driven. Education Bachelor's degree or equivalent professional work experience. Pay Range The typical pay range for this role is: $75,400.00 - $165,954.00 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay range listed above. This position also includes an award reputed company in the company's equity award program. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. reputed company also offers numerous well-being programs, education assistance, free development courses, a reputed company store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | reputed company We anticipate the application window for this opening will reputed company on: 03/17/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply Job!