Network Management and Member Services Manager - HCA Healthcare

Description

The estimate displayed represents the typical salary range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range.

Introduction

Do you want to join an organization that invests in you as a(an) Manager Data Management? At HCA Healthcare, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.

Benefits

HCA Healthcare, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
• Free counseling services and resources for emotional, physical and financial wellbeing
  
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
  
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock
  
• Family support through fertility and family building benefits with Progyny and adoption assistance.
  
• Referral services for child, elder and pet care, home and auto repair, event planning and more
  
• Consumer discounts through Abenity and Consumer Discounts
  
• Retirement readiness, rollover assistance services and preferred banking partnerships
  
• Education assistance (tuition, student loan, certification support, dependent scholarships)
  
• Colleague recognition program
  
• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
  
• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

You contribute to our success. Every role has an impact on our patients’ lives and you have the opportunity to make a difference. We are looking for a dedicated Manager Data Management like you to be a part of our team.

Job Summary and Qualifications

GENERAL SUMMARY OF DUTIES:

The Manager of Network Management and Member Services is responsible for overseeing the operational activities of the Network Management and Member Services departments

What you will do:

• Supervises a staff consisting of Network Management Associates both in house and remotely, and a Network Management Coordinator whose primary function is to provide provider support/education and interaction with contracted Health Plans (HMO and PPO)
• Responsible for managing network provider education of applicable policies and procedures
• Responsible for supervising daily provider inquiries, including capitation and reimbursement issues 
• Assist in development of physician communication programs and strategy
• Responsible for maintaining strong relationships with contracted Health Plans (HMO and PPO) Communicates with payors and network providers, both orally and written, in association with operational and contractual related issues
• Oversees client related projects 
• Assist in identifying issues, problems, and areas where performance could be improved
• Represent PPMSI at physicians’ offices, contracted health plans, and committees when necessary
• Develop and present educational pieces at network provider meetings
• Primary responsibility for periodic statistical performance reporting of Network Mgt activities
• Insure adequate physician network retention, expansion and recruitment
• Assist with the development of strategic plans for servicing network physicians and members
• Develop, recommend, and implement new policies and procedures when appropriate

What you will need:

• Advanced knowledge of managed care market, strategies, and physician compensation models
• Working knowledge of medical group/IPA operations
• Excellent verbal and written communication skills
• Excellent public speaking and interpersonal skills
• Able to present oneself professionally and have the ability to address large groups of people in educational forums
• Strong research and analytical skills
• Able to research complex contractual documents for interpretive purpose and utilize critical thinking skills
• Willingness to travel locally
• Knowledge of claims payment systems
• Possess excellent problem-solving skills and is able to identify and adapt to shifting priorities

Education: 

• Bachelor’s degree in business, health care or related field, or equivalent experience required

Experience: 

• Four to Five years in health care setting, including progressively more responsible experience in a physician office management or physician relations capacity required
• One to Two years of experience as a manager or supervisor of a department staff

Physician Services Group is skilled in physician employment, practice and urgent care operations. We are experts in hospitalist integration, and graduate medical education. We lead more than 1,300 physician practices and 170+ urgent care centers. We are HCA Healthcare’s graduate medical education leader. We provide direction for over 260 exceptional resident and fellowship programs. We focus on carrying out value-added solutions. These solutions help physicians deliver patient-centered healthcare. We support HCA Healthcare's commitment to the care and improvement of human life.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"Good people beget good people."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder

We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Manager Data Management opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring!

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.