Strategic Health Partnerships & Network Manager

CareSource; Kentucky; On-site; USD 72,000 - 116,000; Full time

Job summary

CareSource is seeking a Health Partner Network Manager to execute contracting strategies, develop provisions based on cost and quality, and monitor key metrics for the assigned Market. This role focuses on value-based reimbursement, provider recruitment, and contract loading/credentialing.

You will analyze financial data, establish rates with leadership, and ensure compliance with regulatory requirements while building networks to support new products in the market.

Qualifications

• Bachelor’s degree in a healthcare field or equivalent years of relevant work experience is required.
• Master’s degree preferred.
• Minimum of three years of healthcare experience, including one year in managed care provider relations or provider contracting.
• Managed care experience is highly preferred.

Responsibilities

• Create, execute and administer value based reimbursement strategies as directed.
• Conduct annual effectiveness review of contracting strategies.
• Ensure corporate compliance with all contracting initiatives.
• Recruit, contract and initiate loading and credentialing processes for providers.
• Negotiate and re-negotiate hospital, ancillary and physician contracts within policy.

Skills

Negotiation skills

Provider Network Management

Microsoft Outlook

Microsoft Word

Microsoft Excel

Communication skills

Education

Bachelor’s degree in healthcare

Master’s degree

Tools

Excel

Outlook

Word

Job description

CareSource is seeking a Health Partner Network Manager to execute contracting strategies, develop provisions based on cost and quality, and monitor key metrics for the assigned Market. This role focuses on value-based reimbursement, provider recruitment, and contract loading/credentialing.

You will analyze financial data, establish rates with leadership, and ensure compliance with regulatory requirements while building networks to support new products in the market.