Ewings Associates, Inc. Provider Network Manager in Boise, Idaho

Reference # :17-00018Title :Provider Network ManagerLocation :Boise, IDPosition Type :ContractExperience Level :Start Date / End Date :09/11/2017 / 12/29/2017 Description

Healthcare Network Development Contractor in Idaho. EWINGS, INC. is in search of a healthcare network development professional that can help build a network of physicians for beneficiaries that are active members of the military (Tricare) in the State of Idaho. CANDIDATES MUST HAVE EXPERIENCE WORKING IN THE IDAHO MARKET AND BE AVAILABLE TO START BY SEPTEMBER 11th. If candidates do not currently reside in Idaho but have experience working in Idaho, they must be able to work during normal business hours in the Idaho time zone. This is a temporary, telecommuter assignment that is scheduled to last 4 months, ending on December 29, 2017. Consultant will be a 1099, Independent Contractor working for EWINGS, INC.POSITION DESCRIPTION: Develop the provider network of physicians yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners. Provider network contractor will evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining strong business relationships with Physicians, and potentially other providers ensuring the network composition includes an appropriate distribution of provider specialties. In this role, you will be expected to identify solutions to non-standard requests and problems, solve moderately complex problems and/or conduct moderately complex analyses and work with minimal guidance in a telecommuting compacity.QUALIFICATIONS: It is very important that candidates have experience working with physicians in Idaho and have Tricare experience. However, all candidates will be considered. Undergraduate degree, 4+ years of experience in a network management-related role, such as contracting or provider services. Managed care work experience contracting or recruiting a range of healthcare providers including physicians, hospitals, specialists, ancillaries. In-depth knowledge of reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS) preferred 3+ years of experience utilizing financial models and analysis in negotiating rates with providers. At least an intermediate level of knowledge of claims processing systems and guidelines. 3+ years of experience in performing network adequacy analysis. Intermediate level of experience with MS Excel required. Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others. Strong interpersonal skills, establishing rapport and working well with others. Experience working in a high performing team environment that focuses on productivity and achieving results.