Job DescriptionThis position is responsible for developing and implementing a strategic plan that meets the customer requirements within budget plan and assures access to a network of services that supports member access and are within cost of care plans. The position is responsible for delivering insight into product development and operational improvements.
- Manages network to meet the needs of the SBU, clients and members.
- Ensures unit cost targets are met.
- Assures long term mutually successful provider relationships.
- Directs all provider (free standing facility, hospital, and in-office) recruitment activities for national providers and provider vendors.
- Assumes lead role in negotiations with key providers as required.
- Hires, trains and provides supervision, development and mentoring of staff in meeting objectives and functions.
- Develops negotiation strategies to ensure results are within financial projections.
- Measures performance of individual team members, balances work loads and develops hiring plans to meet network development needs.
- Provides guidance on fee schedule development, underwriting and unit cost trend management.
- Manages financial goals (e.g., control care cost trends, profitability) as defined by the business operations and the SBU, including assuring that the network is cost effective, marketable, stable and offers appropriate access.
- Monitors ongoing provider performance changes in cost and utilization needs.
- Supports strategy for new products/product enhancement with product development division.
- Develops and maintains positive relationships between Magellan and providers and influences and changes behavior of providers in accordance with business operations goals and objectives.
- Prepares, analyzes, reviews and projects financial/systems impacts of various negotiation strategies.
- Develops and analyzes RFPs to support contracting initiatives.
- Supports sales on RFPs and participates in sales presentations to prospective clients.
General Job Information
TitleVP, Network - Magellan Complete Care
Job FamilyOperations Group
CountryUnited States of America
FLSA StatusUnited States of America (Exempt)
Recruiting Start Date5/14/2019
Date Requisition Created5/14/2019
Work ExperienceManaged Healthcare, Management/Leadership, Network, Process Improvement
EducationGED, High School
License and Certifications - Required
License and Certifications - PreferredPMP - Project Management Professional - Enterprise
Other Job Requirements
- Bachelor's Degree in Business Administration.
- 10+ years’ experience in managed care.
- 8 years of management level experience in the managed healthcare industry.
- Demonstrated negotiation and influencing skills.
- Demonstrated financial analysis and decision-making skills.
- Demonstrated process improvement knowledge.
- Knowledge of the variety of financial and operational structures viable in the managed care arena, including value based payment models.
- Strong analytical and organizational skills in a multiple site and matrixed environment.
- Advanced Microsoft Office Suite knowledge, specifically Excel.
- Master's Degree in Healthcare or Business Administration
- Process Improvement experience
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.