Director Provider NEtwork Dev GHP-Arkansas

Job ID: J131285
Company: Gateway Health Plan
Location: Little Rock, AR, United States
Full/Part Time: Full time
Job Type: Regular
Posted at: Sep 7, 2018

Share:

Description

JOB SUMMARY

This job functions as the Director of Provider Network Development for the Arkansas PASSE (Forevercare) line of business and develops and implements strategies for expanding the network of providers, leading a team of staff in the development, expansion, and contracting of providers; documenting pertinent information regarding potential providers; communicating with team on priority areas for development, supporting sales and RFP requirements on mapping/analysis; and strong financial preform analytic skills to understand the strategic impact of network affiliations and provider contracts. The incumbent is accountable for ensuring that the company secures stable provider networks that meet and/or exceed contractual access standards and accessibility in addition to formulating and administering department policies.


ESSENTIAL RESPONSIBILITIES

  • Perform management responsibilities including, but not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance a management and staff productivity.
  • Maintain executive coordination and collaboration to ensure network development alignment with corporate objectives.
  • Develop strategies and relationship models to address critical success factors across various lines of business for new and existing markets.
  • Interact with current, new, and prospective providers to ensure network expectations are communicated, understood, implemented, and maintained.
  • Coordinate network changes with all appropriate departments and design process improvements for inter-department communication.
  • Review and implement changes to contracting operations to assure accurate processes and minimize inefficiencies and maximize cost savings.
  • Develop, produce, and distribute indicator reports and provider report cards.
  • Represent provider network on cross-functional teams and meetings, including new market rollout and network expansion.
  • Other duties as assigned or requested. 


EDUCATION

Required

  • Bachelor’s degree in Business or Health Administration


Substitutions

  • None

Preferred

  • None

EXPERIENCE

Required

  • 5 years of experience in provider network development    
  • 3 years of Medicare and Medicaid experience

Substitutions

  • None

Preferred

  • 8 years of experience required in provider network development
  • 5 years of experience in Medicare and Medicaid
  • Experience with provider profiling and alternative payment strategies 


LICENSES or CERTIFICATIONS

Required

  • None

Preferred

  • None

SKILLS

  • Possess a strong background in implementation and process improvement for provider network development 
  • Develop and maintain strategic level relationships with key medical delivery system partners  
  • Strength in leadership and teamwork, strategic thinking, influencing skills, negotiating skills, and operations execution
  • Experience with financial terminology and analytics


Languages (Other than English)

None

Travel Requirement

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-Based

Teaches / trains others regularly

Frequenly

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

Occasionally

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

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Frequently

Lifting: 10 to 25 pounds

Rarely

Lifting: 25 to 50 pounds

Rarely

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 position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

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

Share:

Interested in working at the Highmark Health enterprise?
Take the first step by joining our Talent Network today!

Join Our Talent Network

Similar Jobs

Provider Account Liaison

Allentown, PA, United States
Provider Services

Associate Provider File Representative

Pittsburgh, PA, United States
Provider Services

Associate Provider File Representative

Pittsburgh, PA, United States
Provider Services

Population Health Performance Specialist-Central PA

Home, PA, United States
Provider Services

Dental Network Service Representative

Home, VA, United States
Provider Services

Pay for Value Practice Specialist - Pittsburgh North Shore

Pittsburgh, PA, United States
Provider Services

Privileging Specialist

Jefferson Hills, PA, United States
Provider Services

Associate Provider File Representative

Pittsburgh, PA, United States
Provider Services

Provider Account Liaison

Wilkes-Barre, PA, United States
Provider Services

Provider Account Liaison

Camp Hill, PA, United States
Provider Services

Provider Enrollment Specialist

Erie, PA, United States
Provider Services

Provider Partnership Consultant

Pittsburgh, PA, United States
Provider Services

Provider Enrollment Specialist

Pittsburgh, PA, United States
Provider Services

Provider Partnerships Consultant

Camp Hill, PA, United States
Provider Services

Senior Provider Contracting Consultant-2

Home, NC, United States
Provider Services