Sr Provider Network Mgr (Behavioral Health) - San Diego, CA - 39 - (US-CA-San Diego - 92199)

Minimum Education: Tech School
Job Type: Full Time
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WellPoint
is the nation's leading health benefits insurer and a Fortune Top 50 company. At WellPoint, we are dedicated to improving the lives of the people we serve and the health of our communities. WellPoint strives to provide the best health care value for our customers.

Bring your expertise to our innovative, achievement-driven culture, and you will discover lasting rewards and the opportunity to take your career further than you can imagine.

Sr Provider Network Manager

Responsible for developing the behavioral health provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. This level typically works with the most complex providers at least 50% of the time. Complex providers may include, but are not limited to institutional providers, large medical groups and ancillary providers, providers in areas with strong competition or where greater provider education around managed care concepts is required. Contracts involve non-standard arrangements that require a high level of negotiation skills. Fee schedules are often customized. Serves as key resource for other contracting staff and provides mentoring and on-the-job training and development. May serve as lead over a contracting team engaged in less complex negotiations. Works independently and requires high level of judgment and discretion. May work on projects impacting the business unit requiring collaboration with other key areas or serve on enterprise projects around network management as needed. May collaborate with team in making presentations to employer groups. Essential duties may include, but are not limited to: Serves as a communication link between professional providers and the company. Conducts more complex negotiations and drafts documents. May prepare financial projections and conduct analysis as required. Performs other duties as assigned.

Skills:
* Requires BA/BS and 5-7 years experience in contracting, provider relations, provider servicing or any combination of education and experience that would afford equivalent competencies.* Experience should include prior contracting experience.* Must have exceptional oral and written communication skills, strong analytical skills, and PC skills.* Must demonstrate leadership skills.* Requires occasional travel. WellPoint is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2009 DiversityInc magazine Top 50 Company for Diversity.

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