LTSS Service Coordinator managing member care plans and assessments in Ohio for chronic illnesses. Focusing on person - centered care through face - to - face and telephonic interactions with clients.
About the role
- Senior Manager managing provider contracts and network performance in a hybrid role at Alignment Health. Focused on enhancing contracted provider experience and achieving key performance metrics.
Responsibilities
- Responsible for contracting with all provider types
- Collaborate with Network Management leadership in developing contracting strategy
- Recruit providers to eliminate network deficiencies
- Negotiate and finalize all contracts
- Manage staff and assure day-to-day operations of the provider network are consistent with standards
- Develop agendas and lead Joint Operations Meetings to drive results
- Ensure accurate and timely data reporting requirements are being met
- Research, analyze and resolve complex problems
Requirements
- Minimum 5-7 years’ experience with HMO, managed care provider organization or insurance company
- 5 years’ specific experience in managed care contracting
- Bachelor’s Degree or equivalent experience required
- Proficient in MS Office, with strong Word and Excel proficiency
- Ability to read and interpret contracts and government regulations
Benefits
- Health insurance
- Retirement plans
- Paid time off
- Flexible work arrangements
- Professional development
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