Job Details: Manager Provider Relations

Company: Health Net, Inc – With the support of more than 9,500 Health Net associates, we're building secure futures for our members, and at the same time, for our company.

Description: Health Net, Inc. (NYSE: HNT) is among the nation's largest publicly traded managed health care companies. Health Net's mission is to help people be healthy, secure and comfortable.
Health Net, Inc. (NYSE: HNT) is among the nation's largest publicly traded managed health care companies. Health Net's mission is to help people be healthy, secure and comfortable. The company's POS, HMO, insured PPO, behavioral health and government contracts subsidiaries provide health benefits to more than 7 million individuals. For more information on Health Net, Inc., please visit the company's Web site at www.healthnet.com .

JOB SUMMARY:
The Manager of Provider Relations is responsible to develop, recruit and service provider/practitioner network activities. In addition, this individual is responsible to assist with and coordinate the Plan's interaction with providers/practitioners to install a recognition and perception amongst providers/practitioners that the Plan is the premier provider servicing managed care organization in its state.

ESSENTIAL DUTIES AND RESPONSIBILITIES:
• Supervises, manages and directs some of the provider servicing activities in the assigned region, including but not limited to, network expansion, routine servicing, issue resolution, retention, and interacting with providers/practitioners and hospitals as requested.
• Works with market and regional staff to identify, recommend and execute network expansion opportunities: areas of need" throughout the service area d and appropriately recruit providers/practitioners to meet these needs. Emphasis is currently placed on professional PPO recruitment and may expand to include other products/provider types.
• Assist with ensuring that the provider network in place is able to service the needs of members consistent with benefit plan requirements. Develops approach to improve and enhance the image of the company with providers/practitioners.
• Assures the success and appropriateness of the physician education process, including but not limited to, new physician education, implementation of company policies and procedures, and compliance with strategic Company initiatives.
• Some oversight of the daily activity and workload, including training, of the Provider Network Administrator and Provider Network Coordinator staff.
• Designated lead, as requested, within the department for various regulatory and compliance activities, including but no limited to DMHC filings.
• Routine interface with internal staff on a cross functional basis
• Maintains a service oriented and physician friendly atmosphere within the Provider Network Management staff.
• Maintains the customer service standards of the Provider Network Management area.
• Assists with special projects, or other duties as identified and assigned by Regional Network Director.
• Travel may be required up to 20% of the time.


REQUIREMENTS:
Education:
Bachelor's degree in health related field required; MBA preferred.

Experience:
• Minimum four years experience working in a health care delivery system and/or provider servicing in the health industry is required.
• Minimum three years experience working in a professional capacity with health care providers is required.

Knowledge, Skills & Abilities:
• Excellent verbal, written and interpersonal skills are essential.
• Requires high degree of organizational skills.
• CPT coding and knowledge of physician office management experience required.
• Ability to conduct educational seminars and effectively address groups as required.
• Must be knowledgeable in PC software and have ability to utilize a variety of software programs.
• Ability to travel throughout the service area.
• Analytical abilities are essential for report and data interpretation.
OR
Any combination of academic education, professional training or work experience, which demonstrates the ability to perform the duties of the position.
For immediate consideration please click Apply to Job, locate this position by Job Number 08001088, scroll down, click on job title and apply online.

Health Net, Inc. supports a drug-free work environment and requires pre-employment background and drug screening. Health Net and its subsidiaries are an Equal opportunity/Affirmative Action Employer M/F/V/D.

Posting Date: Jul 18 08