Network Management Manager

• Manages contract performance, and drives the development and implementation of value-based contract relationships in support of business strategies
• Recruits providers as needed to ensure attainment of network expansion and adequacy targets
• Accountable for cost arrangements within defined groups
• 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
• Responsible for identifying and managing cost issues and collaborating cross functionally to execute significant cost saving initiatives
• Represents company with high visibility constituents, including customers and community groups
• Promotes collaboration with internal partners
• Evaluates, helps formulate, and implements the provider network strategic plans to achieve contracting targets and manage medical costs through effective provider contracting to meet state contract and product requirements
• Collaborates with internal partners to assess effectiveness of tactical plan in managing costs
• Ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information

3 to 5 years working experience in contract performance

Knowledge and experience problem solving

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility