Responsible for developing and executing the strategic direction for Managed Care Networks.Facilitates the management of provider networks.Responsibilities
- Interacts on various projects, administration of policies and procedures with various areas in managed care operations; including credentialing, network performance, care management, and provider registration. Identifies opportunities to improve the overall process of expanding the network.
- Manages the staff on daily basis. Provides leadership and negotiation strategy to the department. Trains and develops contracting staff on the policies and procedures of the department and to increase individual effectiveness and reduce errors.
- Facilitates all network management activities including the formulation and recommendation of overall strategies and objectives across all function areas.
- Interacts with network providers to resolve problems that impact customer satisfaction or network development and retention.
- Implements all policies and procedures related to network management. Monitors departmental staff to ensure that policies are adhered to.
- Administration of corporate projects that involve network management.
Qualifications Education and Experience:
- Bachelor's Degree in Business Administration, Healthcare Administration or related field.
- 8 years of healthcare industry sales or provider experience of which 3 were in a leadership position.
Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:
A Great Place to Work:
- Top Workplace in Northeast Ohio. Year after year we've received this recognition!
- On-site wellness center at most locations. Enjoy personal trainers, towel service, locker room, weight room, elliptical machines, and a variety of classes!
- On-site cafeteria serving hot breakfast and lunch, at most locations. Choices ranging from salad bar, made to order, hot and cold sandwiches, or a variety of entrees cooked fresh daily. Convenience store at most locations
- Employee discount program. Discounts at many places in and around town, just for being a Medical Mutual team member
- Business casual attire
Excellent Benefits and Compensation:
- Competitive compensation plans
- Employee bonus program
- 401(k) with company match and an additional company contribution
- Excellent medical, dental, vision, and disability insurance
An Investment in You:
- Career development programs and classes
- Mentoring and coaching to help you advance
- Education reimbursement up to $5K per year
About Medical Mutual:
We strive to create peace of mind. Our customers can trust us to do things right and to help them get value from their health plan. We're the largest health insurer in Ohio and for over 85 years, we've been serving our members and the Ohio communities where they live and work. Medical Mutual is a Top Place to Work in Northeast Ohio with exceptional career opportunities that offer challenge, growth and a great work/life balance. We want talented, innovative, and driven people to help us continue to be the best health insurance choice of Ohioans and help make Ohio the best it can be! Our headquarter building is located in the heart of downtown Cleveland and we have multiple offices throughout the state. Join us at one near you!
At Medical Mutual we celebrate differences and are mutually invested in our employees and our community. We are proud to be an Equal Employment Opportunity and Affirmative Action Employer. Qualified applicants will receive consideration for employment regardless of race, color, religion, sex, sexual orientation, gender perception or identity, national origin, age, marital status, veteran status, or disability status.
We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.
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