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As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

POSITION SUMMARY

The Senior Manager, Business Consultant is an individual contributor role with the following responsibilities:

• Supports health plan or Market with expansion initiatives ensuring Vendor Network recruits providers to ensure network expansion goals, achieve regulatory and/or internal adequacy targets or other contracting activities as needed.
• Collaborates cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities.
• Subject Matter Expert support for questions related to network initiatives, contracting, provider issues/resolutions, related systems and information contained.
• Provides guidance and shares expertise to others on the team.
• Manages high level projects and recruitment initiatives with interdepartmental resources and/or cross functional stakeholders.
• Holds JOC meetings.
• Supports or assists with operational activities that may include, but are not limited to, database management and contract coordination.

• Performing statistical analysis of data.

  Preparing statistical analysis and dashboard reports to present to leadership.

PREFERRED QUALIFICATIONS

Dental Vendor Experience

EDUCATION

Bachelor’s degree desired and/or equivalent work experience

FOR THIS ROLE YOU WILL NEED MINIMUM REQUIREMENTS

• 7+ years of provider contracting experience
• Knowledge of Medicare and Medicaid programs.
• Ability to travel nationally as needed (up to 25% travel)
• In-depth knowledge of the managed care industry and practices, as well as a strong understanding of strategies, practices, and financial/contracting arrangements.
• Adept at problem solving and decision making skills
• Adept at collaboration and teamwork
• Adept at growth mindset (developing yourself and others) skills
• Adept at execution and delivery (planning, delivering, and supporting) skills
• Adept at business intelligence

The Senior Manager, Business Consultant is an individual contributor role with the following responsibilities:

• Supports health plan or Market with expansion initiatives ensuring Vendor Network recruits providers to ensure network expansion goals, achieve regulatory and/or internal adequacy targets or other contracting activities as needed.
• Collaborates cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities.
• Subject Matter Expert support for questions related to network initiatives, contracting, provider issues/resolutions, related systems and information contained.
• Provides guidance and shares expertise to others on the team.
• Manages high level projects and recruitment initiatives with interdepartmental resources and/or cross functional stakeholders.
• Holds JOC meetings.
• Supports or assists with operational activities that may include, but are not limited to, database management and contract coordination.
• Performing statistical analysis of data