Network Manager

Southern California Permanente Medical Group; Atlanta (GA); Vor Ort; USD 90.000 - 140.000; Vollzeit

Zusammenfassung

Kaiser Permanente/ The Southeast Permanente Medical Group in Atlanta seeks a Network Manager to oversee region-wide contracting strategies, manage IPAs, PHOs, and key specialty services, and align contract interests across TSPMG and Network providers.

You will analyze financial reports, identify cost savings, ensure contract compliance with state and federal requirements, and support value-based contracting initiatives while recruiting providers to meet expansion targets.

Qualifikationen

• 3–5 years of experience in managed care contracting/provider relations.
• Bachelor’s Degree required.
• 5+ years of experience in managed care contracting preferred.

Aufgaben

• Develop, manage, and implement Region-wide contracting strategies for KaISER Permanente’s Southeast region.
• Align contract interests of TSPMG and Network providers.
• Collaborate with Finance to identify cost savings and monitor contract performance.

Kenntnisse

Managed care contracting

Provider relations

Contracting analytics

Negotiation

Cross-functional collaboration

Ausbildung

Bachelor’s Degree

Jobbeschreibung

Kaiser Permanente/ The Southeast Permanente Medical Group

Network Manager

This position reports to the Director of Physician Contracting to support the contracting activities of the Southeast Permanente Medical Group. Contracting activities continue to grow to meet the need of membership, financial impact, and complexity. Existing contracts must be continually renegotiated and aggressively managed. The Network Manager position is expected to manage outside medical cost through contracting initiatives, analysis of financial reports and trends in the marketplace. Areas of responsibility will include IPAs, PHOs, and key specialty services. Manages contract performance and supports the development and implementation of value-based contract relationships in support of business strategies. Will recruit providers as needed to ensure attainment of network expansion and adequacy targets.

Major Responsibilities/Essential Functions

• Develop, manage, and implement Region-wide contracting strategies. This includes specialty services and the
• alignment of contract interests of TSPMG, and Network providers.
• Accountable for cost arrangements within defined groups. Collaborates cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities.
• Manages contract performance and supports the development and implementation of value-based contract relationships in support of business strategies.
• Manage contractual relationships and ensure accurate administration of contract terms. Lead and participate in
• multidisciplinary teams comprised of claims, UM, credentialing, contract configuration and other teams as needed.
• Collaborate with Finance to identify cost savings initiatives and monitor contract performance.
• Ensure contract compliance with all requirements as set forth by State and Federal agencies.

Minimum Education

• Bachelor’s Degree

Minimum Work Experience and Qualifications

• 3-5 years of experience in managed care contracting/provider relations

Preferred Work Experience and Qualifications

• 5+ years of experience in managed care contracting

The Southeast Permanente Medical Group (TSPMG) is one of Georgia’s largest independent, physician-owned, multi-specialty medical groups. More than 600 physicians and 200 associate practitioners work together in a unique integrated care modelto provide high-quality care to over 315,000 Kaiser Permanente members. Care is delivered at 26 medical offices featuring state-of-the-art equipment, labs, imaging services, and pharmacies. We also provide surgical services and around the clock care at some of the area’s top hospitals.

TSPMG offers a competitive salary, a generous retirement package, paid time off, health, dental, vision, and life insurance, long and short-term disability, relocation allowance, and more. We also offer numerous clinical and non-clinical learning opportunities and physician leadership development.

Atlanta, our home for more than 30 years, is a thriving metropolis that blends southern charm with modern art, music and culture. Learn more aboutour beautiful southern city at http://www.atlanta.com/.

We are an equal opportunity employer. All applicants will be considered for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, veteran or disability status. We maintain a drug and nicotine free workplace and perform pre-employment substance abuse testing.