Network Manager - Little Rock, AR - Sage Health

Sherwood, AR 72116

About the Job

About Sage Health

We believe all seniors regardless of means deserve concierge primary care & wellness, without the concierge fees. They've earned it.

Sage Health builds enriching neighborhood health centers that are easy to access, provide or arrange for all of our patients' healthcare needs, and partner with Medicare Advantage plans that fully cover primary care. Unlike other physician practices, a Sage Health physician has a patient panel of 400 or less, and we collaborate with the best outcomes-oriented specialists and hospitals in each market. Because we are not a fee-for-service provider and manage patients within a global capitation budget provided by Medicare Advantage plans, our only concern and motivation is to keep our seniors healthy.

Sage Health is a destination for the best risk provider talent in the country who are building the new standard-bearing senior model for the United States.

All applicants are considered for all positions without regard to race, religion, color, sex, gender, sexual orientation, pregnancy, age, national origin, ancestry, physical/mental disability, medical condition, military/veteran status, genetic information, marital status, ethnicity, citizenship or immigration status, or any other protected classification, in accordance with applicable federal, state, and local laws. By completing this application, you are seeking to join a team of hardworking professionals dedicated to consistently delivering outstanding service to our customers and contributing to the financial success of the organization, its clients, and its employees. Equal access to programs, services, and employment is available to all qualified persons. Those applicants requiring an accommodation to complete the application and/or interview process should contact team@sage.health.

About the role

The Network Manager is responsible for identifying and establishing relationships with value-based high-quality providers i.e. hospitals, specialists, home health care agencies, etc. to build Sage Health ‘s own specialty network based upon our contracted health plan network. Additionally, the network manager will support the referral process and post-acute services. The Network Manager will also be responsible for delivering medical cost performance targets in partnership with center and market leadership.

What you"ll do

Ensure patient information remains secure and confidential.
Maintains a safe, secure, and healthy work environment by following Sage Health policy and procedures, complying with legal regulations.
Build productive relationships within all departments in the Health Plan i.e. Provider Relations, Network, Hospital Service, Contracting, HEDIS/Quality, etc.
Establishes a value-based, high-quality network of providers i.e. specialists, hospitals, DME, and Home Health Care, etc. on the contracted Health Plans network.
Influence Health Plan to add specialists to their network based upon their cost effectiveness and quality.
Develops strategic and contractual relationships in the market with hospitals and specialists.
Evaluates and recruits" onsite specialist as needed and prepares contract and terms i.e. independent contractor or employment.
Responsible for the recruitment, interview, hire, training, and performance evaluation of direct reports i.e. Referral Manager, etc.
Partners with the center and market leadership in the interview and selection of clinical and non-clinical staff i.e. Referral Manager, Referral Coordinator, Primary Care Physicians, etc.
Develops and implements policies, procedures, and work standards and monitors adherence.
Responsible for achieving medical cost targets and partners with corporate analytics, Chief Medical Officer, or designee to identify opportunities for improvement.
Implement or recommend disciplinary action as needed in conjunction with Human Resources. Document all disciplinary action.
Ensures each center within the market has access to the following facilities electronic health record, hospital, imaging centers, skilled nursing facilities, etc.
Holds regular cadence of meetings, and communications with the following: referrals, physician, post-acute, and operations leadership.
Identifies additional services that will drive value-based care for our members.
Perform other duties as assigned.

Qualifications

B.S. degree in healthcare management/administration
Managed care experience i.e. Medicare HMO, D-SNP
Knowledgeable of reimbursement methodologies: hospital, DME, and outpatient settings.
Knowledge of health care issues and a variety of facilities, hospitals, or physician offices procedures, concepts, and practices.
Minimum eight (8) years of managed care operations experience in a Health Plan, Hospital or Medical Group setting.
Minimum five (5) years of people management experience
Excellent interpersonal, written, presentation, and verbal communication skills.
Experience running reports and analyzing data.
Ability to develop strong relationships.
Experience working with payors, inpatient (hospitals), physician groups, outpatient facilities (skilled nursing facilities).
Must be organized and attentive to detail.
Ability to manage competing priorities.
Ability to work in a fast-paced environment.
Resourcefulness in problem solving.
Ability to influence.
Able to take and follow through with assigned tasks and accountability.
Experience working with an electronic health record.
Experience with Microsoft Office Word, PowerPoint, Outlook, and Excel.
Experienced working in medically underserved/culturally diverse communities.
Must be willing to travel to centers within market or other locations i.e., new markets, corporate.
Full COVID-19 vaccination (including boosters) an essential requirement of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements.

PI239964724

Source : Sage Health