At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence.
MANAGER, GOVERNMENT PROGRAMS AND NETWORK DEVELOPMENT
Work From Home
Long-distance or air travel as needed - not to exceed 10% travel
Direct Reports: (1) Network Development Coordinator
Under the direction of the Director, the Network Development Manager will support the provider networks for CIN & ACO operations in the BSMH Ministry He/she is responsible for the maintenance of the provider networks, including, but not limited to: agreement maintenance, provider database maintenance, liaison with Central Verification Office and Payer Enrollment team, liaison with providers and office staff for issue resolution, liaison with payers and internal personnel for issue resolution, education of office staff and providers on new programs, services, operational and compliance requirements, and developing appropriate reports to monitor and assess network activities.
Essential Functions:
• Manages and tracks all Mercy population health provider agreements and required documentation.
• Manages communication with Central Verification Office and Payer Credentialing teams for accurate network rosters.
• Supports value-based contract requirements (Medicare Shared Savings Program and other payers). -includes ACO call line, CMS submissions, value-based payer support, and bundles
• Communicates with Markets to resolve issues, provide support for operational requirements, and assist with education and training for Mercy Health Select providers
• Leads the development, reporting of standardized and ad hoc reports to evaluate and monitor network performance, including analyses of variances, trends and comparison.
• Provides and promotes excellent customer service for both internal and external customers. Holds self and others accountable for behaviors that promote service excellence.
• Troubleshoots problems and issues regularly on behalf of the team.
• Performs other duties as assigned and needed by the network
• Supports the development and tracking of population health compliance programs
• Supports managing the Network Exception Process for BSMH employee health plan contracts
• Partners with analytics to monitor, track and report network makeup and development.
• Monitors the publicly available information related to competitor’s network development in population health programs
REQUIRED:
• 4 year/ Bachelors Degree
• 5 years healthcare business experience
• Proficient in Mircrosoft Office (Word, Excel and Powerpoint)
PREFERRED:
• Graduate Degree (Masters)
• Knowledge or experience in healthcare, health plans, and/or of provider network development
☒ Combination of post-secondary education and/or experience in lieu of a degree
Many of our opportunities reward* your hard work with:
Comprehensive, affordable medical, dental and vision plans
Prescription drug coverage
Flexible spending accounts
Life insurance w/AD&D
Employer contributions to retirement savings plan when eligible
Paid time off
Educational Assistance
And much more
• Benefits offerings vary according to employment status
All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email recruitment@mercy.com. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com
