Creates and implements corporate strategies, policies and initiatives to assigned geographic region, health system or line of business. Oversees the company's relationships with physician, professional, institutional and ancillary providers including negotiation and implementation of contracts and reimbursement strategies with the goals of achieving the best- in- market mix of cost, access and quality to contribute to and enhance corporate performance goals.
- Develops provider-centered initiatives in order to increase quality and reduce costs for book of business and for specific customers. Works directly with Sales and other areas to achieve Customer satisfaction.
- Oversees the development, implementation and administration of the institutional, professional and ancillary provider network, contracting, financial reimbursement and incentive strategies.
- Oversees the management of the department whose goals include: maintaining appropriate provider access; reduction and/or control of health care costs; strong provider satisfaction; effective provider education; and staff learning and development.
- Reviews proposed contracts and manages multiple concurrent negotiation processes to achieve annual local and regional network targets related to cost, access and quality.
- Works with internal resources and external providers and others to support corporate participation in governmental and/or specialty products as they are developed.
- Assists in the preparation of materials necessary for regulatory compliance processes to ensure network achieves and maintains all accreditations.
- Performs other duties as assigned.
- Bachelor's degree in Business Administration, Health Care Administration or related field or equivalent combination of training and experience.
- Master's degree in Business Administration (MBA) or Health Care Administration (MHA) preferred.
- 8years progressively responsible health care administration experience with strong preference for managed care experience.
- 5 years experience in a leadership role.
- Experience in establishing and maintaining provider networks for specific products including government programs.
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 and its family of companies 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.
Apply on company website