Network Representative

ChenMed; Richmond (VA); On-site; USD 59,251 - 84,643; Full time

Job summary

ChenMed is seeking an experienced healthcare network manager in Richmond, VA. This role involves managing relationships with preferred specialty providers, driving adherence to the network, and collaborating with various stakeholders including clinical teams.

Qualified candidates should have a BA/BS in a related field, 3–5 years of healthcare experience, and a strong proficiency in Microsoft Office tools. The position requires extensive travel and working flexible hours to meet organizational needs.

Qualifications

• Advanced skill in Microsoft Office Suite including Excel, Word, and PowerPoint.
• Ability and willingness to travel locally and regionally up to 80% of the time.
• Healthcare experience in a Medicare HMO population is a plus.

Responsibilities

• Manage preferred specialty provider network and stakeholder consultation.
• Drive adherence to the specialty provider network.
• Participate in clinical and operational meetings for network feedback.

Skills

Advanced-level business acuity

Strong communication and presentation skills

Exceptional organizational skills

Team-oriented collaboration

Fluency in English

Education

BA/BS degree in Healthcare or related field

3-5 years’ work experience in Healthcare

Tools

Microsoft Office Suite

Job description

Essential Job Duties/Responsibilities

• Curation and management of the preferred specialty provider network in consultation with internal stakeholders
• Building relationships with preferred specialty providers to drive their behaviors and gaining mutually beneficial commitments to progress specialist relationships through the maturity framework
• Frequent rounding with preferred specialty providers leveraging analytics resources to inform about shared goals, collaboration, communication, referrals, medical cost performance, and levels of service
• Direct accountability for referrals adherence to the preferred specialty provider network
• Communication and education with clinical, operations, Referrals, and Specialty and Medical Centers COEs about the specialty network
• Collaboration with Health Econ and Specialty and Medical COEs to analyze medical cost opportunities for interventions within the Network scope
• Participate in Center clinical and operational meetings, e.g., Transforming Care Meetings (TCMs), to gain specialist network feedback and provide Network and medical costs education
• Drive preferred specialist network adherence by collaborating with Center Dyads and Referrals to analyze, identify opportunities and support improvement initiatives within Referrals including workflow, productivity, leakage and consult tracking
• Proactively and independently manage specialist network plans of action, analytics needs, and rounding schedules
• Agility to adapt strategies and tactics to changing market and company dynamics
• Examine obstacles from various perspectives to develop new and creative solutions when other attempts fail
• Strong communication and presentation skills
• Support communication and collaboration with health plans at the city/area and regional levels
• Performs other duties as assigned and modified at the Network Director’s discretion

Knowledge, Skills and Abilities

• Advanced-level business acuity
• Comprehensive knowledge and understanding of general/core job-related functions, practices, processes, procedures, techniques, and methods
• Advanced skill in Microsoft Office Suite products including Excel, Word, PowerPoint and Outlook; competent in other systems required for the position
• Ability and willingness to travel locally, regionally and/or nationally up to 80% of the time; flexible to work evening, weekends and/or holidays as needed
• Team-oriented with the ability to work extremely well with patients, colleagues, physicians, and other personnel in a professional and courteous manner
• Exceptional organizational skills with the ability to effectively prioritize and timely complete tasks
• Spoken and written fluency in English
• This job requires use and exercise of independent judgment

Education and Experience Criteria

• BA/BS degree in Healthcare or related field is required OR additional experience above the minimum may be considered in lieu of the required education on a year-for-year basis
• A minimum of 3-5 years’ work experience in Healthcare or related field is required
• Healthcare experience within the Medicare HMO population is a plus
• A valid, active driver's license in State of employment is required; position may require travel within the market
• Prior experience working in a Medicare Managed Care environment preferred

Pay Range

$59,251 - $84,643 Salary. The posted pay range represents the base hourly rate or base annual full‑time salary for this position. Final compensation will depend on a variety of factors including but not limited to experience, education, geographic location, and other relevant factors. This position may also be eligible for bonuses or commissions.