drjobs Network Manager, Payor Strategy and Network Development - Managed Care Contracting - Full Time 8 Hour Days (Exempt) (Non-Union)

Network Manager, Payor Strategy and Network Development - Managed Care Contracting - Full Time 8 Hour Days (Exempt) (Non-Union)

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1 Vacancy
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Job Location drjobs

Los Angeles, CA - USA

Monthly Salary drjobs

$ 95680 - 158230

Vacancy

1 Vacancy

Job Description

The Network Manager Payor Strategy and Network Development is responsible for supporting the development implementation and maintenance of USCs Health Plan Network. This role focuses on identifying network gaps assisting with provider contracting strengthening relationships with network providers and supporting integration and network operations alongside Keck Medicines Value Based Services Organization (VBSO). The Network Manager reports to the Associate Administrator of Payor Strategy and Network Development but also collaborates closely with internal stakeholders across legal finance operations health plan leadership and the VBSO to help ensure a high-performing strategically aligned provider network. Key responsibilities include analyzing network composition and access evaluating provider performance data and identifying opportunities for network growth operational improvement and alignment with value-based care initiatives. The Network Manager serves as a key point of contact for network-related operational matters working directly with internal health plan and health system partners to promote efficiency and effective collaboration. This role also contributes to broader health plan strategy initiatives including support for health plan analytics contract review provider onboarding and strategic expansion efforts. Additional duties may include maintaining accurate network documentation and assisting with data tracking related to contracts operational outcomes. Strong analytical skills knowledge of managed care operations and contracting experience with value-based care models and building strong relationships with both internal and external partners are essential. The ideal candidate is highly organized able to manage multiple priorities independently and comfortable working across teams to support USCs network and payor strategy goals.

Essential Duties:

  • Analyze and identify health plan network gaps to support network development and contracting efforts.
  • Assist with provider contracting strategies and onboarding to address identified network deficiencies.
  • Manage and maintain relationships with health plan network providers in collaboration with internal teams.
  • Support the integration of network providers with Keck Medicines Value Based Services Organization (VBSO).
  • Collaborate with legal finance operations and other stakeholders to ensure network operations are aligned with organizational goals.
  • Review provider and health plan performance metrics to identify trends risks and opportunities for improvement.
  • Maintain accurate and up-to-date network documentation and provider data.
  • Support special projects and payor strategy initiatives including network expansion and performance improvement efforts.
  • Assist in resolving network-related operational issues and provider escalations.
  • Perform other duties as assigned in support of the Payor Strategy and Network Development team

Required Qualifications:

  • Req Bachelors Degree Business Administrative or related field
  • Req 4 years Experience in Managed Care/Network Development experience in Payor/Medical Group/Hospital environments.
  • Req Strong understanding of health plan network development and provider contracting.
  • Req Familiarity with managed care principles value-based care models and network adequacy standards.
  • Req Knowledge of California healthcare market.
  • Req Excellent interpersonal skills with the ability to build and maintain strong provider and payor relationships.
  • Req Strong analytical and problem-solving skills; able to interpret and act on provider and payor performance data.
  • Req Proficient in tracking and maintaining network documentation provider rosters and contract performance metrics.
  • Req Strong project management skills to manage multiple projects and priorities independently.
  • Req Highly organized with strong attention to detail and follow-through.
  • Req Effective verbal and written communication skills for collaboration with internal teams and external partners.
  • Req Proficiency in Microsoft Office Suite including Word Excel PowerPoint and Outlook.


Preferred Qualifications:

  • Pref Masters degree Business Administrative or MPH related field
  • Pref Knowledge of California regulatory landscape including Medicare Medi-Cal and Commercial requirements
  • Pref Experience working with Academic Medical Centers and complex health systems.

Required Licenses/Certifications:

  • Req Fire Life Safety Training (LA City) If no card upon hire one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)

The annual base salary range for this position is $95680.00 - $158230.00. When extending an offer of employment the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position the candidates work experience education/training key skills internal peer equity federal state and local laws contractual stipulations grant funding as well as external market and organizational considerations.

USC 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 disability or any other characteristic protected by law or USC policy. USC observes affirmative action obligations consistent with state and federal law. USC will consider for employment all qualified applicants with criminal records in a manner consistent with applicable laws and regulations including the Los Angeles County Fair Chance Ordinance for employers and the Fair Chance Initiative for Hiring Ordinance and with due consideration for patient and student safety. Please refer to theBackground Screening Policy Appendix Dfor specific employment screen implications for the position for which you are applying.

We provide reasonable accommodations to applicants and employees with disabilities. Applicants with questions about access or requiring a reasonable accommodation for any part of the application or hiring process should contact USC Human Resources by phone at or by email at. Inquiries will be treated as confidential to the extent permitted by law.

If you are a current USC employee please apply to thisUSC job posting in Workday by copying and pasting this link into your browser:

Experience:

Manager

Employment Type

Full-Time

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