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Providence Health & Services Network Contract Manager, Behavioral Health Program in Portland, Oregon

Description:

Providence St. Joseph Health is calling a Behavioral Health Network Manager to our location in Portland, OR.

Providence is seeking an entrepreneurial contracting whiz who can build and maintain a new Behavioral Health network for our Providence Health Plan. This is an ideal opportunity for someone invigorated by the challenge of growth, who loves developing new teams and processes, and who thrives in that business development and negotiation space. If this sounds like you, we'd love to chat!

In this position you will have the following responsibilities:

  • Develop and manage Oregon and SW Washington network of affiliated health systems, hospitals, IPAs, physician groups, and other health care professionals.

  • Develop and deliver oral and written presentations of Providence opportunities for provider partnership with Vice President of Network Development, Service Area Chief Executives, Director of Risk and Reimbursement, Chief Financial Officer and Chief Medical Director.

  • Define risk models and contracting options that meet the needs of the local behavioral health community, purchaser, health plan and health system with Service Area Executive, Medical Directors, Vice President of Network Development and Director of Risk and Reimbursement.

  • Manage provider recruitment process in Oregon and SW Washington for health plan products.

  • Take lead or assist in negotiation of integrated IPA, physician group, facilities, and hospital contracts in concert with the Manager of Contracting, Vice President of Network Development, Chief Financial Officer and Director of Risk and Reimbursement.

  • Maintain ongoing relationship with affiliated providers through regular meetings and communications with local behavioral health leadership.

Qualifications:

Required qualifications for this position include:

  • Bachelor’s degree in business administration, finance, health care administration, nursing or equivalent.

  • 3 year’s progressively responsible experience in managed health care

  • 3 years of Supervisory Experience.

  • 3 year’s experience in managed care contract negotiations with IPAs, medical groups, independent physicians, hospitals, health systems, and physician hospital organizations.

  • Valid Oregon or Washington driver’s license and reliable personal transportation.

  • Demonstrated exceptional oral (public speaking) and written communication skills with emphasis on persuasion. Must be able to communicate with medical professionals as well as other audiences.

  • Requires a detailed understanding of contract issues involved in provider credentialing, regulatory requirements, hold harmless clauses, patient access and grievance, operational parameters, contract assignment language, a variety of payment methodologies, and several different risk and incentive arrangements.

  • History of positive working relationships with providers, especially physicians, that demonstrates credibility and trust.

  • Strong problem solving and analytical skills.

  • Detailed understanding of provider risk/reimbursement concepts.

  • Detailed knowledge of health plan operations and its impact on provider network.

  • Ability to operate and adapt in a fast-paced, complex, and dynamic environment.

  • Ability to review utilization and cost information, and communicate trends and assist in developing action plans for improvement.

  • Demonstrated ability to develop key staff to allow for appropriate delegation of responsibilities.

About Providence in Oregon

As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities.

The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs. At Providence, our quality vision is simple,

"Providence will provide the best care and service to every person, every time."

Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon.

We offer a full comprehensive range of benefits - see our website for details

http://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Health Plan/Insurance Nursing

Location: Oregon-Portland

Req ID: 219690

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