Director, Network Development

United States

Job Description

This position is responsible for the development of Magellan’s pharmacy provider network portfolio inclusive of Commercial and Government lines of business, managing assigned providers, assuring network adequacy, ensuring network pricing competitiveness, development of network designs in response to unmet needs, and contracting with qualified service providers in compliance with federal and state laws. This role will lead Magellan's strategy and planning in the successful development of the pharmacy provider network portfolio including network development, contracting both language and reimbursement aspects of legal documents and analytical review as well as interpretation of network/provider utilization.

o    Leads network planning and strategy efforts to support the successful transformation of the various delivery system

o    Plans, develops and ensures implementation and positive outcomes of Magellan’s network portfolio including contracting both language and reimbursement aspects of Commercial and Government based legal documents, analytical review as well as interpretation of network and provider utilization

o    Manages a portfolio of pharmacy providers inclusive of but not limited to retail pharmacies, specialty pharmacies, long term care pharmacies, home infusion pharmacies, 340B pharmacies, Indian Tribe, Tribal Organization or Urban Indian Organization Pharmacies

o    Ensures compliance with contracting, pricing, and P&L targets

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General Job Information

Title

Director, Network Development

Grade

29

Job Family

Operations Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

2/3/2020

Date Requisition Created

2/3/2020

Work Experience

Network

Education

Bachelors

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

Significant experience in progressive network management and development. Knowledge of NCQA requirements.8+ years managed healthcare 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.