What are the responsibilities and job description for the Provider Network Development Manager position at WelbeHealth?
At WelbeHealth, we are transforming the reality of senior care by providing an all-inclusive healthcare option to our most vulnerable senior population by serving as both a care provider and care plan to the participants we serve.
Our Health Plan Services team is making it possible for our seniors to receive top-quality clinical care within their communities. The Network Development Manager helps ensure this by obtaining and developing provider partnership contracts (Medicare & Medi-Cal) in our existing and future markets in order to best serve our participants’ elaborate care needs.
This role will be managing our Northern California market locations (San Jose, CA - Stockton, CA - Modesto, CA - Fresno, CA)
Essential Job Duties:
- Regularly assess and meet participant needs for provider contracts across PACE programs in WelbeHealth and help build specialty-based provider network across our Southern California territories
- Prepare contract templates and negotiate optimal rates within Medi-Cal/Medicare and value-based environments across varying methodologies (specialties, hospitals, ancillaries, skilled nursing facilities, nonstandard PACE providers)
- Coordinate post-contract implementation and contract loading with cross-functional teams and market-based leadership
- Establish strong relationships with contracted partners and ensure partner satisfaction
Job Requirements:
- Minimum of three (3) to five (5) years of experience in contract negotiation, managed care, healthcare administration, with at least three (3) years of direct experience in Medicare/Medi-Cal contracting required
- Ability to comprehend and oversee contracting across varying regulatory environments and requirements
- Proven success leading network development efforts as a new entrant health plan
- Bachelor’s degree preferred, or an additional four (4) years of experience in lieu of education
- Local to the greater Northern California region with the willingness to travel on-site as needed to providers’ offices, hospitals, etc.
Benefits of Working at WelbeHealth: Apply your provider relations expertise in meaningful ways as we rapidly expand. You will have the opportunity to design the way we work in the context of an encouraging and loving environment where every person feels uniquely cared for.
- Medical insurance coverage (Medical, Dental, Vision) starting day one of employment
- Work/life balance – we mean it! 17 days of personal time off (PTO), 12 holidays observed annually, sick time
- Advancement opportunities - We’ve got a track record of hiring and promoting from within, meaning you can create your own path!
- And additional benefits
