Leads and manages a development team in building Medicare compliant networks for MAPD expansion target markets to include contracting physicians, facilities and ancillary services. Identify community providers to secure compliant network, communicate and orient on HealthSpring’s delivery model to engage and reimburse physicians and providers consistent with the operational model. Closely work with Cigna colleagues to coordinate outreach and identify and target providers. Initiate HealthSpring market leadership to maintain positive relationships between the health plan, physician and providers. |
Responsible for oversight of provider network recruitment and contracting for targeted markets. Provides guidance on strategic plans, vision, and action plan development for the network builds. Responsibility for network build which includes physician contracting, rate negotiations, network relationships, network communication, physician recruitment, and network partners. Participates in network and Company meetings, including physician board of directors, quality management, financial/bonus, operation, committee. Serves as a mentor to other Administrators. Supervises others.
Minimum: Bachelor’s degree; At least three years related experience.
Preferred: IPA experience. Master’s degree. Experience in physician relations or managed care.
Cigna - 2 years ago
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