Network Leadership for the Louisiana and Mississippi market. Responsible for negotiating the most complex and challenging contractual relationships with providers and develop value based strategies for the market. Works cross-functionally within the region to ensure consistency with all contracting strategies and maintains overall accountability for medical cost management within the market.
Fundamental Components
Formulates the overall network strategy used to manage medical costs and develop value based strategies for Louisiana and Mississippi market.
Negotiates complex, competitive provider contracts with significant financial implications and manages relationships with key providers and health systems.
Partners with Medical Economics team to assess effectiveness of tactical plan in managing costs.
Supervises day-to-day operations of network management teams including all Provider Relations and contract negotiating staff.
Provides network strategy support to sales and marketing along with assistance on community relations related items when required.
Comprehensive understanding of hospital and physician financial issues and how to leverage technology to achieve quality and cost improvements for both payers and providers.
BACKGROUND/EXPERIENCE Desired
In-depth knowledge of managed care business, regulatory /legal requirements, products, programs, strategy and objectives.
Comprehensive understanding of hospital and physician financial issues and how to leverage technology to achieve quality and cost improvements for both payers and providers.
Solid leadership skills including staff development.
EDUCATION
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
FUNCTIONAL EXPERIENCES
Functional - Network Management/Contract negotiation/4-6 Years
Functional - Network Management/Network market leadership/1-3 Years
Functional - Network Management/Provider relations/1-3 Years
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