Manager Network Contracting

Company :

Helion

Job Description : 

JOB SUMMARY

Lead team responsible for managing our business partnerships with health care providers and vendors in our operating regions. This includes negotiating and executing contracts that drive high-quality care for our members, while maintaining a competitive cost structure for our company. This role requires accountability, good judgement and instincts, high standards, conviction, and tenacity. Incumbents must coach and develop staff, while encouraging creativity, new perspectives, and collaboration in order to successfully support corporate objectives.

ESSENTIAL RESPONSIBILITIES

• Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.  Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
• Preparation, drafting, and negotiation of regulatory contractual language for complex provider services across all markets. Collect, organize, track, and maintain files and checklists on contractual inventory.
• Act as an expert and resource in all matters relating to establishing network contract templates. Serve as a liaison between Network Services, Network Providers and, HealthNow Legal Department. Oversees outside regulatory agency audits regarding network contractual matters under the supervision of HealthNow legal counsel.
• Responsible for submitted Legal Tracker matters from Network Services and other related matters, to include updating, tracking, and monitoring matters to ensure accurate record keeping, execution, and follow-up/closure of all matters.
• Review, develop, revise and maintain all contractual templates for new and existing provider services.
• Performs other duties as required.

EXPERIENCE

Required

• 5 years of Healthcare contracting or related experience
• 3 years of Leadership/management 

Preferred

SKILLS

• Ability to read and comprehend various provider contract types including correspondence, law material, and reports.
• Computer literacy required; experience with MS Word, MS Excel and E-Mail. Microsoft Project and Access a plus.
• Ability to perform research using reference materials generally available from regulatory websites and other resources.
• . Able to concentrate on detailed and complicated contractual matters on a frequent basis with occasional interruptions. Attention to detail is constant in this position.
• Able to cope with and work in a fast-paced highly demanding work environment.
• Able to analyze and interpret moderate to complex information and/or data on a frequent basis.
• Knowledge of contracting concepts and procedures.
• Must possess excellent organizational, multi-tasking, and time management skills.
• Excellent verbal and written communication skills.
• High degree of business maturity and demonstrated confidentiality.

EDUCATION

Required

• Bachelors in Healthcare Admin or related field or six years relevant experience in lieu of Bachelor's degree.

Preferred

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• None

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office- or Remote-based

Teaches / trains others

Occasionally

Travel from the office to various work sites or from site-to-site

Occasionally

Works primarily out-of-the office selling products/services (sales employees)

Physical work site required

Yes

Lifting: up to 10 pounds

Occasionally

Lifting: 10 to 25 pounds

Never

Lifting: 25 to 50 pounds

Never

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policy.

Pay Range Minimum:

$78,900.00

Pay Range Maximum:

$146,000.00

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations.  The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

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