Provider Network Senior Manager - Western Pennsylvania

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States.  And we've just started. So join us on this mission!

Job Description

A bit about this role:

The role will be responsible for network development and management along with servicing for an assigned geographic area. The ideal candidate will possess 8+ years experience in recruiting and managing provider networks along with negotiating, reviewing and amending contracts. This experience will include thorough knowledge of contracting with physicians and physician groups, integrated delivery systems, health systems, and ancillary providers using various payment methodologies including fee-for-service and value based / risk. Ideally, the candidate will possess a very high level of business acumen and be able to exhibit it both internally and externally to a wide variety of audiences. Innovation, independence and confidence are key competencies that need to be exhibited. 

Responsibilities will include: 

• Development, maintenance and management of an adequate provider network in assigned geographical area 

• Maintaining relationships and all provider relations activities in assigned geographical area Negotiating and renegotiating contracts with providers as assigned 

• Engage internal subject matter experts and providers to identify opportunities to improve provider / member cost and quality performance 

• Monitoring of various reports to insure all necessary compliance requirements are met and maintained Reporting to leadership current status, risks, and potential opportunities in area of responsibility on a regular basis Support of overall Network Team as required to achieve success for Devoted Health 

• Supporting assigned groups to improve performance in CMS STAR measures

• Travel will be necessary

Attributes to success: 

• Ability to make quick, independent decisions 

• Mutually beneficial negotiation skills

• Strong project management skills Attention to detail Ability to analyze financial and performance reports and identify trends/variances“Big Picture” thinking...Understanding impacts of decisions on network as a whole 

• Extremely effective oral/written communication skills 

• Enterprise mindset

Required skills and experience: 

• Required: Unrestricted driver's license to verify your eligibility and capability to fulfill the driving responsibilities associated with the position

• Required: Must be located in the Western Pennsylvania area (i.e. Pittsburgh, Erie, Altoona, State College, etc.)

• 8+ years negotiating provider contracts including physician / provider group contracts with multiple payment methodologies including value based/risk 

• Provider servicing experience 

• Solid ability to navigate either Google or MS Suite of products 

• High School Diploma or equivalent minimum 

• Experience in CMS STAR measures

• Experience and relationships in the local market
   

Salary range: $74,000 - $145,000 / year

Healthcare equality is at the center of Devoted’s mission to treat our members like family.  We are committed to a diverse and vibrant workforce.  If you lack a specific credential for this position but believe that your strengths and life experiences will propel our mission, we would love to hear from you.

Our Total Rewards package includes:

• Employer sponsored health, dental and vision plan with low or no premium

• Generous paid time off

• $100 monthly mobile or internet stipend

• Stock options for all employees

• Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles

• Parental leave program

• 401K program

• And more....

*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.

The salary and/or hourly range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, years of relevant experience, education, credentials, budget and internal equity).

Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.