Healthcare Network Development Manager (Tc2017-28)

Ewings Associates, Inc.

Reston , VA 20190

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

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Healthcare Network Development Manager (Tc2017-28)

Ewings Associates, Inc.