Company: naviHealth, Inc.
Posted on: August 23, 2019
Job SummaryA highly engaged provider network is critical to ensure
members receive the right care at the right place for the right
amount of time. The Network Manager (NM) is an integral part of the
in-market leadership team, also including: Market Presidents,
Senior Clinical Managers, and Clinical Team Managers. The NM
develops and maintains an ongoing collaborative relationship with
providers, based on mutual respect, high quality outcomes, and
patient satisfaction. The NM works to continually shape the Network
landscape, by offing objective data and education to all
stakeholders in the market. In its highest functional state, it's
the NM whom supports the provider in ensuring recognition by the
hospital and plan partners through appropriate rate setting,
improved volume and achieving and maintaining PAR/Contracted
status. The NM plays a vital role in achieving positive outcomes in
the market including but not limited to: SNF LOS, Discharges to
PAR/Contracted Providers and Closing Clinical Records.
- Develop relationships with providers/payers and supporting the
patient centric model during new implementations.
- Create database of pre-implementation provider metrics (e.g.
readmission rates, ALOS, etc.)
- Coordinate implementation activities (scheduling
dates/locations, speakers/attendees, contact points, deck
preparation, status updates, etc.)
- Create plan approved provider facing educational and summary
- Ensure all necessary logistics are obtained to support a
successful implementation (contacts, EMR access, onsite access,
- Coordinate onsite requirements for naviHealth colleagues (e.g.
credentialing, legal requirements, etc.)
- Maintain positive working relationships with providers/payers
to build a high quality, highly receptive network base in mature
- Serve as main point of contact for providers.
- Deliver provider and hospital performance information at a
- Hold providers accountable for professional collaboration
(based on collaboration agreement), timely delivery of clinical
information, supporting patient and family access to the nH Care
- Evaluate provider receptiveness and quality.
- Lead network issue resolution.
- Proactively identify challenging situations and ensure
appropriate action is taken to mitigate escalation.
- Support providers and respond to questions, concern, and
- Solicit feedback as appropriate (focus groups, survey,
- Work to resolve provider complaints at local, regional, and
- Develop ongoing support materials for providers.
- Analyze and prepare dashboards for providers.
- Coordinate and deliver dashboard information to providers (SNF
and hospital as indicated).
- Provide ongoing education to providers that promotes quality
service and collaboration.
- Work closely with Market Presidents and Senior Clinical
Managers to monitor and improve hospital DC referral patterns, par
and non-par SNF LOS, and closed record statistics.
- Report challenges with care coordinators in the field.
- May participate in network narrowing strategies
- Work closely with Provider Engagement Leadership.
- Analyze data for trends in performance at market, client,
regional, and national levels.
- Support new and existing strategic network initiatives and
programs and communicate to providers.
- Support naviHealth brand marketing.
- Support the onboarding of new network colleagues through
- Work with internal resources on development of preferred
- Support and implements pay for value programs, as
- Assist with contracted network development, as assigned.
- Execute direct contracts with post-acute care providers.
- Participate in contract negotiations and contract language
review including redlining.
- Manage contract load process.
- Perform other duties and responsibilities as required,
assigned, or requested.Qualifications
- Bachelor's degree required
- At least 5 years of experience in a customer facing or Account
Management role required
- Effective negotiation and influencing skills
- Detail oriented
- Ability to build and foster relationships inside and outside
- Ability to independently plan, organize and prioritize
- Willingness to work toward team objectives
- Ability to manage direct reports or team members
- Ability to make appropriate organizational determinations in
accordance with nH standards of practice independently and
- Experienced in managed care, health plan operations in provider
contracting, customer service, or provider relations
- Strong brand promotion and management skills
- Data analytics and reporting experience required
- Proficiency with Microsoft Office applications
- Experience in Acute and Post-Acute Care Continuum a plus
- Clinical Degree may be required, based on the needs of the
- Extensive travel may be required Work Conditions and Physical
- Ability to establish a home office workspace
- Ability to manipulate laptop computer (or similar hardware)
between office and site settings
- Ability to view screen and enter data into a laptop computer
(or similar hardware) within a standard period of time
- Ability to communicate with Clients and team members including
use of cellular phone or comparable communication device
- Ability to sit for an extended period of time periods (1-2)
- Travel requirements
- Up to 75% travel
- Must attend 2 weeks of onsite training at Corporate Office in
Brentwood, TN About naviHealthBeing a pioneer in post-acute
management and care transitions with 19 years of experience,
naviHealth is uniquely positioned to manage patients, improve
clinical and financial outcomes, and share risk with payors and
providers. We provide clinical service support alongside
proprietary technology and advisory solutions that empower health
systems, health plans and post-acute providers to navigate care
episodes across the continuum, with the goal of reducing waste and
improving patient outcomes. Our valuesWe care about the people we
serve.We care about each other.We care about our communities.We
embrace innovation.We like simple. The above statements are
intended to describe the general nature and level of work performed
by colleagues assigned to this job. It is not designed to contain
or be interpreted as a comprehensive list of all duties,
responsibilities, and qualifications. naviHealth reserves the right
to amend and change responsibilities to meet business and
organizational needs as necessary. naviHealth is an Equal
Opportunity Employer. All qualified applicants will receive
consideration for employment without regard to race, color,
religion, sex, sexual orientation, gender identity, national
origin, protected veteran status, or any other protected status
under applicable laws and will not be discriminated against on the
basis of disability.
Keywords: naviHealth, Inc., Eau Claire , Network Manager, Executive , Minneapolis, Wisconsin
Didn't find what you're looking for? Search again!