Manager, Network Development

Job ID: J121078
Company: Highmark Inc
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at: Apr 20, 2018

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Description

General Overview:

The Manager, Network Development creates a competitive advantage through partnering with product, reimbursement, sales, and other operational areas to support the development of innovative network configurations that will meet the overall strategic direction of the organization.  The incumbent is responsible for the innovation and strategic development of the Organization’s provider network and the development of new networks to meet market demands, as well as aiding in the development of Government Programs specific network needs, lead strategies to influence the Organization’s network market competitiveness, and developing contracting strategies that drive the desired outcome of the provider network design. These activities encompass all market segments including Commercial and Government Programs. Leads the planning and implementation of network development activities and resources to meet regional and corporate business goals.

Essential Job Functions:

  • Perform management responsibilities including, but 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.
  • Contribute to and support a comprehensive network strategy for each market segment and business line, Commercial Markets and Government Market Solutions, that ensures we have a plan to develop and implement network designs that ensure our networks are competitive in regards to quality, cost, access, and discount position.
  • Develop innovative provider stratification processes based upon performance on cost, quality, access and other metrics.  Configure networks which meet product requirements.
  • Develop strategies and tactics to improve Blue Cross’ market position with self-insured clients in regards to discount and Total Cost of Care position.  Execute the strategic plan by working collaboratively with other business areas throughout the organization to implement such strategies.
  • Lead cross organizational approach to implementing and maintaining the new and existing network designs.
  • Direct project management to ensure support, project management disciplines and leadership are executed on behalf of various assigned initiatives.
  • Other duties as assigned.

Minimum Qualifications:

  • Bachelor's Degree
  • (Substitution: 6 years of relevant work experience in lieu of degree)
  •  5 - 7 years in the Healthcare Industry

To include

  • 3 - 5 years in Provider Payment/Reimbursement, Data Analytics or Strategic Planning
  • 1 - 3 years in Management

Preferred Qualifications:

  • Network Contracting
  • Provider Negotiation
  • Master's Degree in Business Administration/Management or Health Administration

Knowledge, Skills & Abilities:

  • Analytical Skills
  • Presentation Delivery
  • Influence and Persuasion
  • Financial Analysis
  • Leadership

Referral Award Payout Level: 4

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, 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, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/ProtectedVeterans/Disabled/Sexual Orientation/Gender Identity (http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf)
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
For accommodation requests, please call HR Services at 844-242-HR4U or visit HR Services Online at HRServices@highmarkhealth.org

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