Hospital Based Contracting Manager: AvMed Health Plans

Position Summary:

A major component of AvMed Health Plan’s growth strategy is to be a High Performance Health Plan and to differentiate the Plan through industry leading provider service and relationship management. This achievement requires that AvMed’s provider networks across all markets are competitive with the larger regional and national health plans in discounts, size and composition. The Manager for Hospital Based Physician Contracting shall be responsible for all hospital based physician contracting and servicing for the assigned geographies. The successful Manager will ensure that there is a robust network of participating anesthesiologists, radiologists, pathologists, neonatologists, emergency physicians and hospitalists in the assigned geographies that provide services in AvMed’s participating hospitals and free standing diagnostic, surgery, urgent and outpatient care facilities; that the network of these physician specialists will be contracted at rates comparable to the competition; that strong relationships are built with the physicians and that a high level of service and interaction is provided to insure that their claims are processed accurately and timely; and any issues resolved quickly. Negotiations with these specialists will be planned and prepared for well in advance and completed on time and within the unit cost targets. The manager will ensure that issues that arise with the groups are resolved (whether minor or complex) in a timely, effective and responsive manner. These specialists networks for which the Manager is responsible will have high provider and member satisfaction, be cost effective, and demonstrate a high level of compliance with AvMed’s quality initiatives.

Education/Experience Requirements:

Bachelor’s degree required (in related field) or equivalent work experience. Master’s degree in Business or Healthcare preferred. Three to five years of management experience in health insurance and/or healthcare. Experience working in direct contact with physicians and/or physician office staff. Three to five years of experience in contracting and provider service. Three to five years of management/supervisory experience.

1. Management, planning, organization and communications (verbal and written)

2. Negotiating

3. Contracting

4. Problem identification and resolution

5. Team building

AvMed Health Plans is a Drug/Tobacco-Free Workplace, EOE.