Senior Manager Prof Provider Network Performance - Work From Home

About the role

This position is responsible for managing the development and maintenance of harmonious working relationships with assigned providers, negotiating provider agreements, assigning responsibilities to team members, and leading staff through training, coaching, performance management, and other supervisory responsibilities. As a key member of a cross-functional organization, the Senior Manager oversees the performance and growth of an assigned provider network, partnering with providers and internal stakeholders to drive quality, affordability, operational excellence, and member satisfaction.

Responsibilities

• Manage the development and maintenance of harmonious working relationships with assigned providers
• Negotiate provider agreements
• Assign responsibilities to team members
• Lead staff through training, coaching, performance management, and other supervisory responsibilities
• Oversee the performance and growth of an assigned provider network
• Partner with providers and internal stakeholders to drive quality, affordability, operational excellence, and member satisfaction
• Provide leadership for Provider Performance teams
• Oversee provider network financial performance and value-based initiatives
• Support Stars and Risk Adjustment goals
• Ensure compliance with CMS and company policies
• Collaborate across the organization to strengthen provider relationships, improve health outcomes, and support the continued growth and profitability of the HealthSpring Medicare Advantage business

Requirements

• Bachelor’s Degree in Business or related field plus four years of health care administration or managed care experience
• Eight years of similar experience may substitute
• Effective verbal and written communication skills to interact with all levels of corporate personnel and assigned providers
• Demonstrated analytical abilities and proficient planning skills
• Effective negotiation skills
• Demonstrated ability to meet deadlines and work well under pressure
• Team player/people oriented
• Ability and willingness to travel, including overnight stays
• Individuals must live within 380 miles from the territory serviced

Preferred Job Requirements

• Previous HEDIS and/or CMS STARs experience
• Solid understanding of health insurance, customer messaging/design and project management
• Expert level of Excel preferred (knowledge of pivot tables, VLOOKUP, etc.)
• Experience in financial/trend analysis
• Team player with proven ability to foster and manage working relationships within a matrix environment to obtain buy-in and drive results
• Master's degree, MBA or other relevant degree

Skills

Not specified

Benefits

Not specified

Pay

$92,700.00 - $167,500.00 Exact compensation may vary based on skills, experience, and location

Schedule

Monday - Friday, typical business hours with infrequent evening and weekend meetings

Application Instructions

Not specified

Contact Information

For more information about available benefits, please click here.

We are an Equal Opportunity Employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.