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Network Director - Louisiana Resident

Key Facts

Remote From: 
Full time
Senior (5-10 years)
English

Other Skills

  • •
    Problem Reporting
  • •
    Decision Making
  • •
    Communication
  • •
    Leadership
  • •
    Supervision
  • •
    Team Management
  • •
    Strategic Thinking
  • •
    Mentorship
  • •
    Relationship Building

Roles & Responsibilities

  • 8+ years of progressively responsible health care administration experience (finance/contract administration, physician/provider relations) with strong preference for managed care
  • 3+ years in a leadership role
  • Broad financial expertise with financial modeling experience
  • Bachelor's degree required; Master's degree preferred (or a combination of education and work experience may be considered)

Requirements:

  • Direct strategic and tactical direction of all network activities in the assigned region to develop and maintain provider services delivery system (physician, practitioner, facility, and organization) within budget and cost-of-care targets
  • Develop and implement a Network strategy to secure long-term mutually beneficial relationships with physicians, practitioners, facilities, and organizations, ensuring member access and that Care Management Centers meet cost-of-care plans
  • Direct provider recruitment, credentialing, communications, and relationship-building programs; supervise Field Network Management Department to meet objectives
  • Manage financial goals including cost trends, profitability, network reimbursement and negotiation strategies, and ensure the network is cost-effective and meets access and cost-of-care objectives; establish processes between Network Management and Network Administration (credentialing, data integrity, reporting, rate loading)

Job description

Candidates must be Louisiana residents.

Responsible for the strategic and tactical direction of all activities for an assigned region(s) related to developing and maintaining the physician, practitioner, facility and organization services delivery system. Position is responsible for developing and implementing a plan that meets the customer requirements within budget. Assures access to a network of services that supports member access and that the Care Management Centers (CMCs) are within cost of care plans.
  • Establishes overall direction and plan and working processes between Network Management and Network Administration staff, including credentialing, communication (provider services line, letters, website, etc), database integrity and maintenance, regular reports, and rate loading.
  • Develops and implements a Network strategy to assure long term mutually successful physician, practitioner and facility and organization provider relationships.
  • Directs all provider (physician, practitioner and organizations) recruitment activities.
  • Provides supervision, development and mentoring of the Field Network Management Department in meeting objectives and functions.
  • Manages financial goals (e.g., control care cost trends, profitability) as defined by the business operations, network and CMC senior management team, including assuring that the network is cost effective, marketable, stable and offers appropriate access and CMCs meet cost of care plan.
  • Directs network reimbursement and negotiation strategies in conjunction with business operating unit senior management team to assure CMC is within cost of care plan.
  • Establishes programs to develop and maintain positive relationships between MBH and providers, and to influence and change behavior of providers in accordance with business operations goals and objectives.
The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description.

Other Job Requirements

Responsibilities

- 8+ years of progressively more responsible health care administration experience (finance/contract administration, physician/provider relations) with strong preference for managed care experience.
- 3 years experience in a leadership role.- Broad-scoped financial expertise, with financial modeling experience.

General Job Information

Title

Network Director - Louisiana Resident

Grade

30

Work Experience - Required

Healthcare, Management/Leadership, Network

Work Experience - Preferred

Education - Required

A Combination of Education and Work Experience May Be Considered., Bachelor's

Education - Preferred

Master's

License and Certifications - Required

License and Certifications - Preferred

Salary Range

Salary Minimum:

$105,230

Salary Maximum:

$178,890

This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.

This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.

Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

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