This behaviorial health company is a multi-line managed care organization that provides Medicaid-related programs to organizations and individuals through government subsidized programs. We have an excellent opportunity for a Manager of Provider Relations and Contracting. This position will implement development activities for the recruitment, contracting and retention of providers. Negotiate contracts and develop strategies and methodologies for specific network development initiatives.

Position Responsibilities Include:

• Monitor business processes related to network development to determine their efficiency and protective value, and assure integrity of records, information and systems in compliance with Company policies/standards and government regulations.
• Develop tactical plans to align network strategies and technologies with future needs. Effectively integrate new networking strategies and technologies.
• Oversee marketing efforts in each market.
• Prepare and analyze reports and records on functional area and on organizational activities, recommend improvements for upper management. Monitor and report on achievement of committed action plans to appropriate upper management.
• Monitor operational and financial performance of agreements using results to guide future negotiations.
• Meet individually with providers to develop long-term relationships and resolve operational issues.
• Review redline contract language and provide accept/decline recommendations to management.
• Prepare and analyze information to evaluate the need for additional providers.
• Assist in maintenance of ongoing state governmental and community relationships.

Qualifications

• A Bachelor’s degree.
• 3-5 years experience with project management and supervisory/lead experience.
• Experience in a healthcare or insurance environment, Medicaid preferred.

For additional information, please contact David Mara at 804.527.1905.