Activities & Responsibilities:

• Successful product/plan design, compliance with network requirements, network assessment and selection, and product implementation.
• Network analysis and strategy development, as well as implementation.
• Obtain data, verify validity of data, and analyze data as required.
• Analyze network availability and access.
• Make recommendations regarding use, expansion, and selection of networks for various products based on that analysis.
• Resolve issues within a highly matrixed environment.
• Work with and involve all other relevant segments and units.
• Provide information, advice, and guidance to leadership regarding network issues.

Qualifications:

• Bachelors degree is preferred. Significant additional experience and skills may be considered in lieu of Bachelors degree, at the discretion of hiring manager.
• 5+ years experience working preferably in a network development/contract management, network evaluation, and/or underwriting role is strongly preferred.
• High velocity change agent.
• Drive initiatives to achieve goals.
• Foster competitive environment internally.
• Serve as role model/mentor.
• Consistently demonstrate ability to act and react swiftly to challenges.
• Work collaboratively across functional areas to ensure superior operational efficiency.
• Strong computer skills are essential.
• Expert knowledge of Excel and Access.
• Prefer experience with GeoAccess software.
• High degree of proficiency in network analysis.
• Strong knowledge of managed care and network terminology as well as familiarity with reimbursement methodologies such as RBRVS, ASC groupers, APCs, per diems, case rates, DRGs, fee schedules, and AWP.
• Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others.
• Problem solving skills, including the ability to systematically analyze complex problems, draw relevant conclusions, and successfully devise/implement solutions calmly and effectively.
• Ability to multi-task, shifting back and forth effectively among multiple activities.
• Excellent interpersonal skills.
• Demonstrated leadership skills.