BASIC FUNCTION : This position is responsible for : -development and implementation of strategies for regulatory reporting and compliance -
national provider programs -support for group customer RFPs - provider communications and network management staff education and training -
development or oversight of the policies and procedures in accordance with compliance and quality standards -project management that could include activities such as maintaining and improving provider satisfaction, and development of value-
based or alternative payment programs . JOB REQUIREMENTS : Bachelor Degree and 10 years managed care experience at the health plan level or hospital / health system level, including direct responsibility for health care administration / managed care 5 years management experience at the director level including oversight of management / upper management.
must be familiar with the HMO, PPO and Government product lines and understand how they interrelate Experience with complex managed care concepts in a matrix management environment