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Provider Network Manager

San Rafael, California Apply Now Job ID 1162574 Additional Locations Rancho Cordova,California,US Category Network Development & Contracting Organization Envolve Schedule Full-time
Description:

Position Purpose: The Provider Network Manager manages provider networks for adequacy and access. Conducts high level negotiations and renegotiations of provider contracts. Monitors network adequacy and resolves hospital provider claim issues. Provides regional input and maintenance of provider directory listings. Participates in monthly internal/external meetings involving network activity. Monitors areas credentialing process. Develops provider contracting strategy.

  • Oversees network development and retention strategizing.
  • Oversees network problem resolution (Claims, UM, Etc.).
  • Oversees network analysis for adequacy and recruitment targets.
  • Oversees provider contract negotiations – hospitals, ancillaries, and groups.
  • Provides financial analysis for network development targets.

  • Qualifications:


    Education/Experience: Bachelor’s Degree required; Master’s degree preferred (MBA, MHA). Five to seven years in administration and/or negotiation of managed care contracts

    Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

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    • Network Development & Contracting, San Rafael, California, United StatesRemove
    • Network Development & Contracting, Rancho Cordova, California, United StatesRemove

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