Director, Contracting & Network Management

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Job Details:

Job Overview:
Job Title: Director, Contracting & Network Management
Employer: MMS Group
Location: St. Louis, Missouri
Job Type: Full-Time
Profession: Administrator/Executive
Career Level: Experienced
Experience: 5-10 years
Education Level: Bachelor’s Degree
Travel: 25

Job Description:

Oversee activities of the provider contracting, network development and/or provider relations functions and aid in formulating and administering organizational policies and procedures.

  • Oversee provider contracting activities to ensure efficiency and maintain compliance with the business unit’s policies and standards, government laws and regulations
  • Implement development activities for the recruitment and contracting of provider networks in new and prospective markets, and existing market expansions.
  • Support new business launch in diverse markets while considering individual market circumstances, provider community, budgeting constraints and available resources
  • Perform complex financial analyses to identify medical cost improvement opportunities, develop strategies to reach financial goals, and execute contracting strategies to meet goals and objectives
  • Oversee contracting and network development staff and external consultants in the development of provider networks for new and expansion markets
  • Monitor performance, develop, and implement business solutions to address process and quality gaps, and communicate network strategy and planning
  • Ability to travel Act as provider network subject matter expert for Medicare Advantage and Complex Care (Medicaid-Medicare Partnership, Long Term Supports & Services, Foster Care, etc.) products bringing experience in network management and service area expansions
  • Liaise between corporate product organization, health plan network teams, health plan product teams, and other leaders to deliver on product and network objectives
  • Be able to dig into details, analyze data, develop project plans and development plans
  • Communicate effectively at all levels of the organization

 

Job Requirements:

Education/Experience:

  • Bachelor’s degree in Business Administration, Health Care Administration, related field or equivalent experience.
  • 7+ years of combined contracting, network development or provider relations experience.
  • Previous experience in Medicaid/Medicare contracting and negotiating hospital, large physician groups and ancillary service agreements.
  • Previous management experience including responsibilities for hiring, training, assigning work and managing the performance of staff.

License/Certification: Valid driver’s license.

 

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