Job ID: 296211
Provider Networks Manager
Regular / Day
We Are Hiring
Provider Networks Manager - Full-Time, Days - Virtual
Why Join Ascension?
Ascension Care Management (ACM) creates customized healthcare solutions for health systems, payers, and employers that stabilize costs, improve outcomes, and enhance the experience for both providers and individuals. Our range of services strive to create a seamless healthcare experience for providers, payers and healthcare leaders by improving access to and removing complexity from the delivery of healthcare.
ACM serves 1.3 million patients across the nation and manages more than 20,000 providers through our clinically integrated networks of providers. ACM helps our customers eliminate stress and uncertainty, allowing them to confidently provide quality, value-based services and solutions. Beyond traditional population health management solutions, ACM offers additional expertise in claims management, care coordination, risk management and safety strategies that allow healthcare leaders to avoid challenges and capitalize on healthcare opportunities.
What You Will Do
As a Provider Networks Manager with Ascension System Office, you will have the opportunity to oversee the day-to-day operations and clinical integration activities of provider networks. You will work closely with health system physician services team to further physician alignment and collaboration.
- Oversees productivity and outcomes as defined by Key Performance Indicators (KPI’s). Fosters collaboration between local network stakeholders (i.e. physicians, ancillary partners, and health system leadership).
- Develops and implements a localized strategy for territory/provider management. Analyzes physician quality and utilization data to identify trends. Reviews data with key providers and stakeholders.
- Works with TPAs and payers to address and resolve any claims payments and capitation issues.
- Interprets provider agreements, health plan documents, and applicable rules and regulations. Escalates provider issues within the organization when risks have been identified that affect compliance, safety, stakeholder loss, key timelines or milestones.
What You Will Need
- Bachelor’s degree required.
- 7 years of progressive healthcare, network management, clinical integration, provider contracting, physician relations or related experience required.
- Previous experience in leadership of either people, projects or processes required.
- Previous experience in complex organizational management.
Equal Employment Opportunity
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