Executive Job Description | Morgan Consulting Resources is an executive search firm focusing on the Healthcare Industry for 15 years. We have extensive experience in bringing together leadership talent with organizations that cover all aspects of Healthcare Services - Providers, Payers and Supporting Service organizations. We have been retained to conduct a search for a Director of Network Management
About the organization:
Established in 2008, our client is a management services organization (MSO) providing services to medical groups and IPAs in Los Angeles and Orange County. Our client offers a variety of support services to physician practices, including practice management, billing and collections, and electronic medical record (EMR) implementation. A newer subsidiary, of our client offers a variety of insurance plans for all ages including Medicare beneficiaries.
Our client employs approximately 350 people in areas including: administration, finance, information services, clinical, customer service, and operations. Currently, they contract with over 500 physicians in Huntington Beach, Fountain Valley, Newport Beach, Irvine, Costa Mesa, and Aliso Viejo. Their largest client is the Greater Newport Physicians. The organization prides itself in being a rapid growth company with low turnover.
About the position(s):
Overseeing a staff of 10, the Director of Network Management will report to the Chief Operating Officer. They will be responsible for the following areas: Contracting, Provider Relations, Credentialing and Network Research (under two Managers: Manager of Network Management, Manager of Provider Enrichment). The successful candidate will have:
- Bachelor’s Degree in Health Administration, Business Administration or related field;
- A minimum of five years of managed care experience; and,
- A minimum of five years in a management role.
We are looking for someone with a strong analytical background, excellent negotiating skills and strong knowledge of physician contracting (code driven and fee for service). The ideal candidate will come from a hospital, physician group or IPA.
Skill requirements include a demonstrated history of partnering effectively with providers and an ability to execute with an orientation toward best practices and long-term relationships with providers. A strong management philosophy to oversee a high performing team and a willingness to work collaboratively with peers is a must in this environment. Also, the ability to work with data, analyze financial impact of contracts and work within budgets is essential. Excellent communication skills are paramount. See attached position description for more details.
Our client provides medical/dental/vision insurance, Paid Time Off, 401K and much more. Please email or call us with questions or recommendations of candidates you feel we should consider for this excellent opportunity.
Rosie Saenz, Principal
rosie@morganconsulting.com
(702) 968-8050 ext. 201
Director of Provider Network Management
The ideal candidate will possess outstanding relationship building skills and will be accountable for the following management responsibilities:
• Direct all goals and production of the Network Management department providing clear leadership to the staff.
• Collaborate with management and staff from other departments to develop processes, resolve issues and further the business goals.
• Advise senior leaders on provider network strategies to meet the needs and goals of our client physician groups.
• Lead or oversee the negotiation and renegotiation of provider contracts and letters of agreement.
• Oversee the credentialing and re-credentialing of all physician and ancillary providers. Maintain compliance with NCQA and health plan credentialing standards.
• Direct all aspects of the provider relations functions, including provider education, training and problem resolution.
• Act on behalf of client IPAs as a liaison to health plans to facilitate resolution of operational issues.
• Experience with contract modeling and analysis is strongly preferred.
• Qualifications:
o Bachelor’s degree in Health Care Administration, Business Administration or related field. Masters degree preferred.
o Minimum of 5 years experience in managed care.
o Minimum of 5 years experience in a management role.
Our client offers a complete benefits package including medical/dental/vision insurance, Paid Time Off, 401K and much more.
We pride ourselves on our efficiency, professionalism and commitment to our clients while maintaining our primary focus on customer service and helping people.
E.O.E.
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