RPMGlobal
Corporate Provider Network Management Network Development Manager
RPMGlobal, Newtown Square, Pennsylvania, United States
Corporate Provider Network Management Network Development Manager
Location
Remote, United States
Primary Job Function
Medical Management
This position is remote eligible with a strong preference of Eastern time zone resident.
Job Summary This position is responsible for building and maintaining provider networks that meet state and CMS requirements for new products and market expansion. This role leads network development projects, creates and manages performance and status reporting, and ensures timely execution of growth strategies. The Manager collaborates with the Corporate Provider Network Management (CPNM) leadership to design business plans, process flows and strategies aligned with new market needs.
Work Arrangement This position is remote eligible with a strong preference for Eastern time zone resident.
Project Management & Reporting Responsibilities
Provide project management oversight of new business implementations and market expansions, including set up and maintenance of project sites, folders, and repositories (MS Teams, SharePoint or shared drives).
Develop and maintain performance metrics, project status reports and.
Complete CMS Exchange annual provider network filings for assigned growth or expansion markets.
Suggest innovative operational improvements to reduce backlogs and optimize resource utilization.
Coordinate with Communications on tracking document development.
Partner with Legal on new market contracts and timelines.
Coordinate with Corporate Provider Network Operations on provider data discrepancies.
Work with Payment Integrity on contract payment methodologies.
Develop and maintain Standard Operating Procedures (SOPs) for CPNM processes.
Manage special projects as assigned.
Contracting Responsibilities
Provides market intelligence on provider networks in new markets.
Develop provider contracting strategies under the direction of the Director, Corporate Provider Network Development.
Support team members in the identification and creative problem resolution for the improvement of processes and expanded use of technology.
Support Responsibilities
Provides guidance and support to the Corporate Provider Network Management Account Executives.
Stays current on RFP, CMS Filing, and application requirements.
Maintains accurate records of provider contracts.
Support process improvement and technology adoption initiatives.
Assist with new staff orientation and training as needed.
Education/Experience
Associate’s Degree required. Bachelor’s Degree preferred.
1 to 3 years People Manager experience.
3 to 5 years Managed Care experience.
Experience with matrixed environment
Proficiency with MS 365; advanced Excel skills required.
Experience with Tableau and Salesforce a plus.
Strong critical thinking, leadership and independent work capabilities
Flexible work solutions including remote options, hybrid work schedules, competitive pay, paid time off including holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k) tuition reimbursement and more.
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Location
Remote, United States
Primary Job Function
Medical Management
This position is remote eligible with a strong preference of Eastern time zone resident.
Job Summary This position is responsible for building and maintaining provider networks that meet state and CMS requirements for new products and market expansion. This role leads network development projects, creates and manages performance and status reporting, and ensures timely execution of growth strategies. The Manager collaborates with the Corporate Provider Network Management (CPNM) leadership to design business plans, process flows and strategies aligned with new market needs.
Work Arrangement This position is remote eligible with a strong preference for Eastern time zone resident.
Project Management & Reporting Responsibilities
Provide project management oversight of new business implementations and market expansions, including set up and maintenance of project sites, folders, and repositories (MS Teams, SharePoint or shared drives).
Develop and maintain performance metrics, project status reports and.
Complete CMS Exchange annual provider network filings for assigned growth or expansion markets.
Suggest innovative operational improvements to reduce backlogs and optimize resource utilization.
Coordinate with Communications on tracking document development.
Partner with Legal on new market contracts and timelines.
Coordinate with Corporate Provider Network Operations on provider data discrepancies.
Work with Payment Integrity on contract payment methodologies.
Develop and maintain Standard Operating Procedures (SOPs) for CPNM processes.
Manage special projects as assigned.
Contracting Responsibilities
Provides market intelligence on provider networks in new markets.
Develop provider contracting strategies under the direction of the Director, Corporate Provider Network Development.
Support team members in the identification and creative problem resolution for the improvement of processes and expanded use of technology.
Support Responsibilities
Provides guidance and support to the Corporate Provider Network Management Account Executives.
Stays current on RFP, CMS Filing, and application requirements.
Maintains accurate records of provider contracts.
Support process improvement and technology adoption initiatives.
Assist with new staff orientation and training as needed.
Education/Experience
Associate’s Degree required. Bachelor’s Degree preferred.
1 to 3 years People Manager experience.
3 to 5 years Managed Care experience.
Experience with matrixed environment
Proficiency with MS 365; advanced Excel skills required.
Experience with Tableau and Salesforce a plus.
Strong critical thinking, leadership and independent work capabilities
Flexible work solutions including remote options, hybrid work schedules, competitive pay, paid time off including holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k) tuition reimbursement and more.
#J-18808-Ljbffr