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Job Details

Senior Provider Network Manager-Hospitals & Health Systems

Requisition #: 191370
Location: Johns Hopkins Health Care, Hanover, MD 21076
Category: Non-Clinical Professional
Work Shift: Day Shift
Work Week: Full Time (40 hours)
Weekend Work Required: No
Date Posted: Sept. 13, 2019

Johns Hopkins Health System employs more than 20,000 people annually. When joining the Johns Hopkins Health System, you became part of a diverse organization dedicated to its patients, their families, and the community we serve, as well as to our employees. Career opportunities are available in academic and community hospital settings, home care services, physician practices, international affiliate locations and in the health insurance industry. Great careers continually advance here.

Reports to the Assistant Director of Provider Relations and is responsible for contracting, network development, education and service for a territory of hospitals and health systems in the Johns Hopkins HealthCare LLC (JHHC), participating network.

Competencies:

A. Education:

Requires Bachelor’s degree in business management or healthcare administration or related discipline.

B. Knowledge:

  • Requires a high level of knowledge of successful selling and negotiation techniques and

an awareness of healthcare contracting terms.

  • Familiarity and knowledge of contracting, recruitment and billing practices of hospitals, facilities and ancillary providers.

C. Skills:

- Requires strong interpersonal skills to effectively communicate and interact with diverse groups of hospitals, health systems, facilities and ancillary and providers, and internal JHHC departments. As well as the skill set to be able to interact with executive level management for complex contractual or operational issues.

- Requires strong written and oral communication skills and ability to calculate complex

Reimbursement factors.

  • Requires advanced computer skills and familiarity with various software applications

(Excel, Access, etc.).

D. Required Licensure, Certification, Etc.:

None.

E. Work Experience:

Requires a minimum of three years prior experience in a contracting role in a health insurance company and preferably 4-5 years of provider relations experience for a health system or health insurance company.

Experience should include: Provider Relations functions, managed care/w facility/ancillary contracting, hospital and health system knowledge of managed care concepts and reimbursement factors. Out of state hospital experience preferred.

F. Machines, Tools, Equipment:

Reliable transportation and the ability to visit multiple providers on a daily basis. PC, PC applications and general office equipment.

Dimensions:

A. Budget Responsibility:

N/A

B. Authority/Decision Making Level:

Responsible for all aspects of network development and management within assigned territory and maintain overall accountability for Provider Relations implementation of JHHC programs.

C. Supervisory Responsibility:

Providers’ daily direction to Provider Relations Coordinators as well as performance evaluation input.

Problem Solving:

Must be able to make independent decisions and use problem-solving abilities to handle complex issues on a daily basis.

Information Management:

Responsible for proper flow and completion of information for provider participation as well as using defined procedures for resolving problems or issues that arise within network. Responsible for financial analysis to determine cost efficient reimbursement factors in contracting with provider network.

Working Conditions:

- Works in normal environment where there are no physical discomforts due to dust,

dirt, noise and the like.

- Work requires extensive travel up to 50% of the work time.

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Johns Hopkins Health System and its affiliates are Equal Opportunity/Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identity, sex, age, national origin, disability, protected veteran status, and or any other status protected by federal, state, or local law.

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