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    Network Management Director - Austin, United States - Curative HR LLC

    Curative HR LLC
    Curative HR LLC Austin, United States

    1 week ago

    Default job background
    Description

    Duties And Responsibilities

    • Manages complex contract negotiations with large and/or complex providers for commercial product lines (e.g., Ancillaries, large physician groups, some smaller hospitals).
    • Proactively builds relationships that nurture provider partnerships to support the local market strategy.
    • Manages key provider relationships and is accountable for critical interface with providers and business staff.
    • Demonstrates comprehensive knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape.
    • Responsible for meeting unit cost targets, while preserving an adequate network, to achieve and maintain competitive position
    • Identify and manages initiatives that improve total medical cost and quality.
    • Prepares, analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms.
    • Partner with Regulatory Affairs to ensure all network filings are timely and accurate.
    • Initiates, nurtures and maintains effective channels of communication with internal matrix partners including but not limited to Claims, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing.
    Requirements
    • Bachelor's degree or equivalent experience in related field, plus 7+ years of work experience beyond degree within provider contracting and/or health insurance
    • Experience in developing and managing key provider relationships including senior executives
    • Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners
    • Intimate understanding and experience with larger, more complex integrated delivery systems
    • Team player with proven ability to develop strong working relationships within a fast-paced organization
    • Nimble to pivot to different strategies, projects and priorities quickly
    • Superior problem solving, decision-making, negotiating skills, contract language and financial acumen
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