Administrative Director Network Management - Provider Contracting - Full Time - Days

Promedica - City Of Maumee
new offer (19/09/2020)

job description

Job Title
Administrative Director Network Management - Provider Contracting - Full Time - Days
Category
Business Professional, Management / Supervisory
Organizational Unit
Location




Maumee, OH 43537 US (Primary)
Job Description
At Paramount, we offer insurance to both large and small groups and also cater to Medicare (Paramount Elite) subscribers in northwest Ohio and southeast Michigan. Our Medicaid product (Paramount Advantage) services those living in the state of Ohio. We maintain an accreditation by the NCQA – the National Committee for Quality Assurance – for our Ohio HMO, Elite and Advantage products. We’re also part of ProMedica, which is ranked the second most integrated health system in the U.S. and No. 1 in the Midwest.
Our mission is to improve your health and well-being. So we’re committed to your wellness with various initiatives, such as preventive services, online knowledge, health risk assessments, our Steps2Health disease management programs, health fairs, and more.
Position Summary:
The Administrative Director Network Management position is responsible for developing and implementing operational relationships, quality controls, strategies and efficiencies/workflows to provide best in class provider network management. This position will direct and ensure appropriate selection and retention of qualified facilities, practitioners and ancillary services for all lines of business in Paramount’s service area. This position will be responsible for overseeing network expansion activities. This position is responsible for developing and implementing operational relationships, quality controls, strategies and efficiencies/workflows to provide best in class contracting, provider service, credentialing, analysis, and provider configuration. Ensure that all interactions with providers meet established targets. Oversee that all departmental projects are timely, accurately and with appropriate approvals.
Job Requirements
REQUIRED QUALIFICATIONS
Education:
Bachelor’s Degree.
Skills:
Demonstrated strengths in problem-solving, negotiation, analysis and organizational skills, excellent oral and written communication skills, and effective interpersonal skills. Ability to plan, coordinate and organize multiple priorities and to work independently. Knowledge of health care delivery systems, CPT coding, and medical terminology required. Experience in using a computer for spreadsheets and word processing required.
Years of Experience:
5-7 year of healthcare industry experience and 3-5 years managing a team of people.
License:
Valid driver’s license &
ability to travel independently throughout Plan’s service area.
ProMedica is a mission-based, not-for-profit integrated healthcare organization headquartered in Toledo, Ohio. It serves communities in 28 states. The organization offers acute and ambulatory care, an insurance company with a dental plan, and post-acute and academic business lines. The organization has more than 56,000 employees, 13 hospitals, 2,100+ physicians and advanced practice providers with privileges, 900+ healthcare providers employed by ProMedica Physicians, a health plan, and nearly 400 assisted living facilities, skilled nursing and rehabilitation centers, memory care communities, outpatient rehabilitation clinics, and hospice and home health care agencies. Driven by its Mission to improve your health and well-being, ProMedica has been nationally recognized for its advocacy programs and efforts to address social determinants of health. For more information about ProMedica, please visit www.Promedica.Org/aboutus.
Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex, pregnancy, sexual orientation, gender identity or gender expression, age, disability, military or veteran status, height, weight, familial or marital status, or genetics.
Equal Opportunity Employer/Drug-Free Workplace
Employee Exemption Type
Exempt
Job Type
Full-time
80
Shift Type
Days
Shift Hours
On-call Requirements
This position can be filled in any one of Paramount’s multiple offices. Paramount has 5 office locations:
Cincinnati, OhioColumbus, OhioMaumee, OhioWarrensville Heights, OhioEvansville, Indiana
ProMedica is a locally owned, nonprofit healthcare organization serving northwest Ohio and southeast Michigan. Driven by our Mission to improve your health and well-being, we offer a full range of diagnostic, medical and surgical specialties in areas such as emergency medicine and trauma, heart and vascular, oncology, orthopaedics, neurology, and women’s and children’s services.

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Administrative Director Network Management - Provider Contracting - Full Time - Days

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