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Network Manager

Company: naviHealth, Inc.
Location: Minneapolis
Posted on: August 23, 2019

Job Description:

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. Responsibilities

  • 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 documents.
    • Ensure all necessary logistics are obtained to support a successful implementation (contacts, EMR access, onsite access, etc.)
    • 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 markets.
      • Serve as main point of contact for providers.
      • Deliver provider and hospital performance information at a regular cadence.
      • Hold providers accountable for professional collaboration (based on collaboration agreement), timely delivery of clinical information, supporting patient and family access to the nH Care Coordinator.
      • 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 suggestions.
        • Solicit feedback as appropriate (focus groups, survey, coalitions).
        • Work to resolve provider complaints at local, regional, and national levels.
        • 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 mentorship.
              • Work with internal resources on development of preferred provider networks.
              • Support and implements pay for value programs, as applicable.
              • 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 the organization
                  • Ability to independently plan, organize and prioritize work
                  • 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 timely
                  • 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 market
                  • Extensive travel may be required Work Conditions and Physical Requirements
                    • 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) hours.
                    • 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

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