Description:
Coventry Health Care, a $12.2 billion Fortune 500 organization, is a national managed health care company with nearly 5.1 million members. At Coventry Health Care, we are driven to ensure that every person and organization we serve receives the greatest possible value for their health care investment. We do this by providing a full range of competitive products through our seven core businesses – Commercial Risk, Medicare Advantage, Medicare Part D, Medicaid, Workers' Comp Services, Federal Employees Health Benefits Plan and Network Rental.
We are committed to constantly improving our low-cost platform so that we can deliver the products and services that our customers want at a price they can afford. Coventry has the expertise, the experience, and the agility to craft the new products, the new processes, and the new service needed to make healthcare more accessible to all Americans.
Our national managed care company is seeking a Director of Network Development in our Louisville, KY office. As a strategic member of the leadership team, the successful candidate will be responsible for network development, provider contracting, contract negotiations and coaching oversight to staff. Establishes and provides oversight of the department’s policies & procedures, and practices. Negotiates contracts, develops strategies and methodologies, contract terms, and alternatives for all contracts pertaining to fully insured, Health Plan, PPO, corporate accounts, lease networks, workers’ compensation, and behavioral health. Implements target cost savings initiatives for a broad base of provider and facility contracts.
We offer a competitive salary, excellent benefits (401K with company matching, comprehensive benefits including medical, dental, and tuition reimbursement), vacation and sick time and a business casual environment. This is a highly visible role dealing with business partners across the corporation, relationship building with vendors and motivating a dynamic team!
ESSENTIAL RESPONSIBILITIES:
• Implements development activities for a broad range of providers (facilities, labs, hospitals, etc.)
• Effectively works with plans to implement cost saving initiatives.
• Negotiates contracts; develops strategies and methodologies for specific initiatives and geographic areas.
• Recruits and contracts with individual providers. Assesses, develops, recruits, and organizes providers for all networks.
• Negotiates complex contracts with physician, ancillary, and hospital providers. Acts in an advisory capacity to the Legal Department with regard to the financial and legal impact of provider contract language requested.
• Serves as the entry point and system of checks and balances between network development and other corporate and plan departments for the purpose of reviewing significant provider contracts for all plans.
• Develops and provides plan support and contracting leadership, as required. Acts as a coach for network development initiatives.
• Compiles, maintains, and analyzes plans’ physician fee schedules including participating PCPs, participating specialists, and non-par physicians for the purpose of identifying cost savings opportunities.
• Compiles, maintains, and analyzes plans’ hospital rates for the purpose of identifying cost savings opportunities leading to local initiatives.
• Reviews and facilitates Requests for Proposals (RFPs) from ancillary providers whose services match a need for entering into a national or regional contract. Analyzes and recommends resolutions of contract barriers, taking into account prevailing local nuances.
• Recruits, develops, and motivates staff. Initiates and communicates a variety of personnel actions including, employment, termination, performance reviews, salary reviews, and disciplinary actions.
• Performs other duties as required.
Qualifications:
Basic Qualifications:
• Bachelor’s degree or equivalent experience.
• 7 – 10 years experience with leadership responsibility. 3 – 5 years management or project lead experience.
• Expert knowledge of provider contracting/negotiations, network development and configuration, standards for managed care delivery and cost containment programs. Substantive knowledge of managed care policy and direction
Preferred Qualifications:
• Strong knowledge of Medicaid; experience managing Medicaid teams in managed care environment.
• Management of strategic operational and technology initiatives.
• Strong working knowledge of MS Excel, computer systems, applications and operating systems.
• Experience managing projects and process innovative changes effectively.
Other:
• Excellent communication skills both verbal and written, and skilled at developing and maintaining effective working relationships.
• Demonstrated leadership and motivation skills.
• Excellent skills in critical thinking and analysis, project management, meeting facilitation, and interpersonal interactions (e.g., partnering, conflict management, consulting etc.)
• Must be able to travel 25%-50%% of time or upon needs of the business.
• Relocation assistance is provided for this position.
Please apply directly to http://jobs.coventryhealthcare.com and refer to Req#1212710, Director, Network Development
Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Job: Executive/Senior Level Officials and Managers
Primary Location: Louisville, KY, US
Organization: 38500 - Coventry Health & Life-KY
Schedule: Full-time
Job Posting: 2012-12-19 00:00:00.0
Job ID: 1212710
Coventry Health Care, a $12.2 billion Fortune 500 organization, is a national managed health care company with nearly 5.1 million members. At Coventry Health Care, we are driven to ensure that every person and organization we serve receives the greatest possible value for their health care investment. We do this by providing a full range of competitive products through our seven core businesses – Commercial Risk, Medicare Advantage, Medicare Part D, Medicaid, Workers' Comp Services, Federal Employees Health Benefits Plan and Network Rental.
We are committed to constantly improving our low-cost platform so that we can deliver the products and services that our customers want at a price they can afford. Coventry has the expertise, the experience, and the agility to craft the new products, the new processes, and the new service needed to make healthcare more accessible to all Americans.
Our national managed care company is seeking a Director of Network Development in our Louisville, KY office. As a strategic member of the leadership team, the successful candidate will be responsible for network development, provider contracting, contract negotiations and coaching oversight to staff. Establishes and provides oversight of the department’s policies & procedures, and practices. Negotiates contracts, develops strategies and methodologies, contract terms, and alternatives for all contracts pertaining to fully insured, Health Plan, PPO, corporate accounts, lease networks, workers’ compensation, and behavioral health. Implements target cost savings initiatives for a broad base of provider and facility contracts.
We offer a competitive salary, excellent benefits (401K with company matching, comprehensive benefits including medical, dental, and tuition reimbursement), vacation and sick time and a business casual environment. This is a highly visible role dealing with business partners across the corporation, relationship building with vendors and motivating a dynamic team!
ESSENTIAL RESPONSIBILITIES:
• Implements development activities for a broad range of providers (facilities, labs, hospitals, etc.)
• Effectively works with plans to implement cost saving initiatives.
• Negotiates contracts; develops strategies and methodologies for specific initiatives and geographic areas.
• Recruits and contracts with individual providers. Assesses, develops, recruits, and organizes providers for all networks.
• Negotiates complex contracts with physician, ancillary, and hospital providers. Acts in an advisory capacity to the Legal Department with regard to the financial and legal impact of provider contract language requested.
• Serves as the entry point and system of checks and balances between network development and other corporate and plan departments for the purpose of reviewing significant provider contracts for all plans.
• Develops and provides plan support and contracting leadership, as required. Acts as a coach for network development initiatives.
• Compiles, maintains, and analyzes plans’ physician fee schedules including participating PCPs, participating specialists, and non-par physicians for the purpose of identifying cost savings opportunities.
• Compiles, maintains, and analyzes plans’ hospital rates for the purpose of identifying cost savings opportunities leading to local initiatives.
• Reviews and facilitates Requests for Proposals (RFPs) from ancillary providers whose services match a need for entering into a national or regional contract. Analyzes and recommends resolutions of contract barriers, taking into account prevailing local nuances.
• Recruits, develops, and motivates staff. Initiates and communicates a variety of personnel actions including, employment, termination, performance reviews, salary reviews, and disciplinary actions.
• Performs other duties as required.
Qualifications:
Basic Qualifications:
• Bachelor’s degree or equivalent experience.
• 7 – 10 years experience with leadership responsibility. 3 – 5 years management or project lead experience.
• Expert knowledge of provider contracting/negotiations, network development and configuration, standards for managed care delivery and cost containment programs. Substantive knowledge of managed care policy and direction
Preferred Qualifications:
• Strong knowledge of Medicaid; experience managing Medicaid teams in managed care environment.
• Management of strategic operational and technology initiatives.
• Strong working knowledge of MS Excel, computer systems, applications and operating systems.
• Experience managing projects and process innovative changes effectively.
Other:
• Excellent communication skills both verbal and written, and skilled at developing and maintaining effective working relationships.
• Demonstrated leadership and motivation skills.
• Excellent skills in critical thinking and analysis, project management, meeting facilitation, and interpersonal interactions (e.g., partnering, conflict management, consulting etc.)
• Must be able to travel 25%-50%% of time or upon needs of the business.
• Relocation assistance is provided for this position.
Please apply directly to http://jobs.coventryhealthcare.com and refer to Req#1212710, Director, Network Development
Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Job: Executive/Senior Level Officials and Managers
Primary Location: Louisville, KY, US
Organization: 38500 - Coventry Health & Life-KY
Schedule: Full-time
Job Posting: 2012-12-19 00:00:00.0
Job ID: 1212710