Network Development Manager

Description:

At WelbeHealth, we are transforming the reality of senior care by providing an all-inclusive healthcare option to our most vulnerable senior population by serving as both a care provider and care plan to the participants we serve.

Our Health Plan Services team is making it possible for our seniors to receive top-quality clinical care within their communities. The Network Development Manager helps ensure this by obtaining and developing provider partnership contracts (Medicare & Medi-Cal) in our existing and future markets in order to best serve our participants’ elaborate care needs.

This role will be remote managing our New Launch Market Locations with 15-25% travel.

Essential Job Duties
 

• Regularly assess and meet participant needs for provider contracts across PACE programs in WelbeHealth and help build specialty-based provider network across our Southern California territories
• Prepare contract templates and negotiate optimal rates within Medi-Cal/Medicare and value-based environments across varying methodologies (specialties, hospitals, ancillaries, skilled nursing facilities, nonstandard PACE providers)
• Coordinate post-contract implementation and contract loading with cross-functional teams and market-based leadership
• Establish strong relationships with contracted partners and ensure partner satisfaction
   

Job Requirements
 

• Minimum of three (3) to five (5) years of experience in contract negotiation, managed care, healthcare administration, with at least three (3) years of direct experience in Medicare/Medi-Cal contracting required
• Ability to comprehend and oversee contracting across varying regulatory environments and requirements
• Proven success leading network development efforts as a new entrant health plan
• Bachelor’s degree preferred, or an additional four (4) years of experience in lieu of education
• Local to the greater Northern California region with the willingness to travel on-site as needed to providers’ offices, hospitals, etc.