Responsible for National provider network management including, development and implementation of corporate network initiatives within CorVel's proprietary networks, specifically the CareIQ Ancillary Care Networks. This individual should have a background in Vendor management, PPO or Specialty/Ancillary network contracting and developing, with strong negotiation skills and management experience.
This is a remote position.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:- Ensures ancillary vendor and provider contracted provider and vendor rates meet corporate requirements and goals; holds account for national contracts' impact on direct expenses and subsequent product profitability, while maintaining strong relationships with vendor/provider representatives.
- Collaborates with local stake holders to improve nationwide and state-by-state networking strategy, contracted rates and outcomes as needed.
- Manages operational and business requirements language utilized in ancillary provider and vendor contracts.
- Reviews and evaluate Facility contract language and rates annually, makes necessary changes in collaboration with all impacted stakeholders, internal and external.
- Identifies National contract opportunities and qualifies potential participants and client nominations.
- Builds familiarity with Workers' Compensation, Auto insurance and Group Health rules and regulations relating to the ability to channel patients, reimbursement schedules, PPO reduction limitations, and etc.
- Works with CorVel Provider Relations staff in educating providers on CareIQ program rules and regulations, contract terminology, and service expectations from participating provider and vendor groups.
- Conducts training calls and impromptu individual training meetings as needed.
- Identifies provider network coverage and service deficiencies and owns the resolution strategy and implementation.
- Manages National provider issues to completion.
- Manages National Network projects and resolutions.
- Manages Network contracts through legal review and approval process.
- Manages National contracts under legal challenge and/or arbitration unto resolution.
- Additional duties as assigned.
KNOWLEDGE & SKILLS: - Strong interpersonal skills and adaptive communication style, complex problem solving skills, drive for results, innovative
- Proven track record of delivering concrete results in strategic projects/programs
- Excellent written communication skills
- Superb attention to detail and ability to deliver results in a fast paced and dynamic environment.
- Proficient in Microsoft applications and able to quickly learn corporate proprietary systems.
EDUCATION/EXPERIENCE: - Bachelor's degree in Business, Health Care Management or equivalent experience.
- Minimum 5 years of experience of PPO network development and/or network management with proven success required.
- Experience managing national ancillary healthcare provider network relationships preferred.
- Experience managing provider/vendor contracts and relationships in the worker's compensation industry preferred.
PAY RANGE:CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.
For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.
Pay Range: $79,704 - $132,692
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.
ABOUT CORVEL CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.#LI-Remote
