Healthcare Network Development Manager (Tc2017-28)

Ewings Associates, Inc. Reston , VA 20190

Posted 4 months ago

Reference # :15-00487Title :Healthcare Network Development Manager (TC2017-28)Location :Reston, VAPosition Type :ContractExperience Level :1 YearsStart Date / End Date :03/01/2016 / 03/01/2017 Description Network Development ConsultantNegotiate contracts with healthcare providers that will service our nations military (Tricare) working for the largest US health insurer. EWINGS has been selected by the largest health insurer in the United States to provide Network Development professionals in advance of the upcoming Tricare (Military Healthcare) contracts.Experienced consultants see these positions as highly coveted opportunities. Our associates that have been on this project team are clamoring to get back on it. This is a chance to contribute to the development of one of the largest healthcare networks ever built - for a very special group of patients, our military and their families.These positions are temporary and may last more than a year. However, an estimated 20%-30% of the contractors on this project team could potentially be offered full-time employment before the end of their assignment. The projected start date is April 1, 2016. Positions are filling up fast, so please provide your hourly compensation expectations along with your application.Network Development Position Description:

  • Develop a provider network with physicians, hospitals, pharmacies, and ancillary groups that is geographically competitive and provides broad healthcare access to patients.

  • Build a stable network that achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners.

  • Evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls.

  • Establish and maintain lasting business relationships with providers, and ensure the network composition includes an appropriate distribution of provider specialties.

  • Provide explanations and interpretations within your area of expertise.

  • Use data and facts to identify and solve problems within your area of expertise.

  • Investigate non-standard requests and manage a wide range of provider issues Qualification

    Requirements:
  • Undergraduate degree or experience equivalent

  • Although the minimum requirement is for 3 years of experience in a network management-related role, such as contracting or provider services, there will be considerable opportunities for highly experienced professionals as well.

  • In-depth knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS).

  • 2+ years of experience in fee schedule development using actuarial models.

  • 2+ years of experience utilizing financial models and analysis in negotiating rates.

  • Intermediate level of knowledge of claims processing systems and guidelines.

  • 2+ years of experience in performing network adequacy analysis.

  • Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others.

  • Strong interpersonal skills, establishing rapport and working well with others. Position Locations:

  • Birmingham AL 35242

  • Little Rock AR 72201

  • Phoenix AZ 85004

  • Tucson AZ 85711

  • Cypress CA 90630

  • Concord CA 94520

  • Sacramento CA 95826

  • Centennial CO 80111

  • Hartford CT 06103

  • Shelton CT 06611

  • Jacksonville FL 32256

  • Maitland FL 32751

  • Miramar FL 33027

  • Tampa FL 33634

  • Norcross GA 30092

  • West Des Moines IA 50266

  • Meridian ID 83642

  • Chicago IL 60601

  • Indianapolis IN 46278

  • Lexington KY 40503

  • Metairie LA 70002

  • Waltham MA 02451

  • Columbia MD 21045

  • Southfield MI 48034

  • Portage MI 49002

  • Maryland Heights MO 63043

  • Helena MT 59601

  • Morrisville NC 27560

  • Charlotte NC 28209

  • Greensboro NC 27455

  • Morrisville NC 27560

  • Charlotte NC 28209

  • Greensboro NC 27455

  • Omaha NE 68164-9672

  • Iselin NJ 08830

  • Albuquerque NM 87113

  • Las Vegas NV 89128

  • East Syracuse NY 13057

  • Islandia NY 11749

  • Kingston NY 12401

  • Cincinnati OH 45242

  • Westerville OH 43082

  • Cleveland OH 44114

  • Tulsa OK 74133

  • Lake Oswego OR 97035

  • Philadelphia PA 19107

  • Pittsburgh PA 15221

  • Warwick RI 02886

  • Columbia SC 29210

  • Brentwood TN 37027

  • Kingsport TN 37660

  • Knoxville TN 37922

  • Memphis TN 38115

  • Austin TX 78746

  • Houston TX 77027

  • Richardson TX 75080

  • Salt Lake City UT 84120

  • Richmond VA 23235

  • Reston VA 20191

  • Seattle WA 98101

  • Wauwatosa WI 53226

Find your dream job anywhere
with the LiveCareer app.
Download the
LiveCareer app and find
your dream job anywhere
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
RFS Project Manager Of Boun...

Mantech International Corporation

Posted 2 days ago

VIEW JOBS 6/23/2018 12:00:00 AM 2018-09-21T00:00 Currently, ManTech is seeking a motivated, career and customer oriented RFS Project Manager of BOUND Network and Content Filtering Requirements to join our team in the Reston VA area to provide unparalleled support to our customer and to begin an exciting and rewarding career within ManTech. The RFS Project Manager of BOUND Network and Content Filtering Requirements provides strategic direction for client interface between customer and a large team of engineers, operations analysts, and other advanced cyber professionals who are focused on the daily operation and maintenance of CDM tools for DHS and civilian agencies. Responsibilities include, but are not limited to: Responsible for the development of CDM projects and direction of BOUND Network and Content Filtering Requirements for our DHS Client Agencies and Customers. Candidate will manage the technical direction of a project through the agile or waterfall process in accordance with project objectives. Position Requirements: * A Bachelor's degree in technical discipline or equivalent project management experience * PMP Certification and ITIL v3 foundations or similar certifications. * Minimum 5-10 years of experience leading process and product requirements development of Continuous Diagnosis and Mitigation (CDM) Projects. Strong knowledge of Ongoing Assessment of IT Solutions. * Strong understanding of industry best practices specifically related to ITIL Foundations, System Development Lifecycle, Agile or Waterfall Methodologies. * Ability to lead and oversee a large project with diverse skill sets in the DHS Community * Experience balancing the demands of multiple clients simultaneously and able to manage multiple tasks and projects in a fast-moving environments * Exceptional customer focus and bias for action * Candidates must have excellent oral and written communication skills * Able to work in matrix environment mentoring a team of professionals responsible for engineering, operation, maintenance of IT applications and tools * Able to build and maintain direct relationships across ManTech's project teams supporting CDM and Agency POCs. Security Clearance: Candidate is required to be a US Citizen and attain DHS Suitability. Candidates with active access will be given first preference. Qualifications 10 to 12 years with BS/BA Degrees See Qualifications Years of Experience See Qualifications Position Type Full-Time Shift Day Overview For more than 40 years, ManTech employees have been solving complex problems for the national security community. We are comprised of approximately 10,000 talented employees around the world. We adhere to the simple, no-nonsense values on which ManTech was founded more than four decades ago, aligning squarely with the mission objectives of our customers. As our customer base continues to expand and diversify, we continue to diversify our workforce and solutions. Half our employees have a military background, and more than 70 percent hold a government security clearance. As a leading provider of innovative technology services and solutions for the nation's defense, security, space, and intelligence communities; we hold nearly 1,000 active contracts with more than 40 different government agencies. Apply Now Save to cart ManTech International Corporation, as well as its subsidiaries proactively fulfills its role as an equal opportunity employer. We do not discriminate against any employee or applicant for employment because of race, color, sex, religion, age, sexual orientation, gender identity and expression, national origin, marital status, physical or mental disability, status as a Disabled Veteran, Recently Separated Veteran, Active Duty Waretime or Campaign Badge Veteran, Armed Forces Services Medal, or any other characteristic protected by law. If you require a reasonable accommodation to apply for a position with ManTech through its online applicant system, please contact ManTech's Corporate EEO Department at (703) 218-6000. ManTech is an affirmative action/equal opportunity employer - minorities, females, disabled and protected veterans are urged to apply. ManTech's utilization of any external recruitment or job placement agency is predicated upon its full compliance with our equal opportunity/affirmative action policies. ManTech does not accept resumes from unsolicited recruiting firms. We pay no fees for unsolicited services. If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accomodation if you are unable or limited in your ability to use or access http://www.mantech.com/careers/Pages/careers.aspx as a result of your disability. To request an accomodation please click careers@mantech.com and provide your name and contact information. © 2010 ManTech International Corporation. All Rights Reserved. About ManTech | Terms of Use | Contact ManTech | EEO Poster Mantech International Corporation Reston VA

Healthcare Network Development Manager (Tc2017-28)

Ewings Associates, Inc.