Provider Network Manager - Carrollton

DescriptionVerda Health Plan of Texas has a contract with the Center of Medicaid and Medicare Services (CMS) and a state license with the Texas Department of Insurance for a Medicare Advantage Prescription Drug (MAPD) plan. We are committed to the idea that healthcare should be easily and equitably accessed by all. Our mission is to ensure that underserved communities have access to health and wellness services, and receive the support needed to live a healthy life that is free of worry and full of joy. We are looking for a Provider Network Manager to join our growing company with many internal opportunities.Are you ready to join a company that is changing the face of health care across the nation? Verda Healthcare, Inc is looking for people like you who value excellence, integrity, caring and innovation. As an employee, you’ll join a team dedicated to improving the lives of our Medicare members. Our vision incorporates value-based health care that works. We value diversity.Align your career goals with Verda Healthcare, Inc and we will support you all the way.Position OverviewThe Provider Network Manager (PNM) serves as the primary source of Provider Relations for assigned territories, which may change from time-to-time with targeted providers in an assigned territory. The PNM coordinates with Network Development team to initiate conversations to introduce Verda Healthcare and to develop communications, with the objective to secure participation agreements in accordance with company policies and procedures. The PNM plays a critical role in increasing Verda Healthcare’s brand with providers by identifying, researching, vetting, and developing an assessment of the provider and the overall business landscape, appropriately identifying providers that align with Verda Healthcare. This individual also supports provider network growth strategies and provider network development in all markets.This position reports to the Senior VP of Operations as part of Verda Healthcare, Inc.Job DescriptionResponsible for provider relations and provider liaison functionsConduct initial outreach and telephonic communication which identify provider interest and qualifies them for contractingIdentify and research resources for developing IPA/Medical group provider leads for new business areas and gaps in provider specialtiesCultivate a deep understanding of market conditions to determine if practices belong to larger systems that contract as single entitiesParticipate in quarterly JOCs and in-servicing providers as necessary to fully serve our members as contractually required. Additionally, assist in provider related issues such as eligibility, member benefits, etc.Work with Executive leadership team regarding strategy, program development, provider recruitment, contracting and onboarding initiativesDevelopment of an adequate provider network in assigned geographical areasMaintaining relationships and all provider relations in assigned geographical area until transition to Local Network is completedReporting directly to the Director for status, risks, and potential opportunities in area on a regular basisMonitor performance, develop, and implement business solutions to address process and quality gaps, and communicate network strategy and planningVendor oversightAbility to travelSpecial Projects as assignedRequirementsMinimum Qualifications Bachelor's degree preferred in Business/Economics, Healthcare Administration, or related fieldMaster’s degree or equivalent preferred5+ years minimum experience in managed care contracting (provider relations, provider network development)Experience with bundled payment contracting or risk and capitation requiredProven track record in negotiations and leading meetings, creating agendas, and achieving goalsProfessional CompetenciesMicrosoft Office and Intermediate computer skillsKnowledge of Network Management Processes & ServicesAbility to manage and prioritize multiple tasks, promote teamwork and fact-based decision makingCommunication skillsAbility to work independently and within a team environmentAttention to detailFamiliarity of the healthcare fieldCritical listening and thinking skillsTraining/teaching skillsStrategic management and Time management skillsProper phone etiquetteDecision making/problem solving skillsResiliency in a changing environmentDemonstrated progression of leadership and responsibilityAbility to work in a fast-paced, start-up cultureProven ability to build, develop, and lead strong teams of operatorsVerda cares deeply about the future, growth, and well-being of its employees. Join our team today!Job Type: Full-timeLocation: Carrollton, TX (Dallas Metropolitan area)Benefits401(k)Paid time off (vacation, holiday, sick leave)Health insurance Dental InsuranceVision insurance Life insuranceScheduleFull-time onsite (100% in-office)Hours of operations: 9am – 6pmStandard business hours Monday to Friday/weekends as neededOccasional travel may be required for meetings and training sessions.Ability To Commute/relocateReliably commute or planning to relocate before starting work (Required)PHYSICAL DEMANDSRegularly sit/walk at a workstation in an office or cubicle setting. Must occasionally lift and/or move up to 25-50 pounds.Other duties may be assigned in support of departmental goals.