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Job Details

Manager ACO Network Relations

Category: Professional and Management
Malden, MA

Department: Population Health Performance
Employment Type: Full Time
Job Type: Non-Union
Work Shift: Days
Work Days: 40
Hours/Week: 40
Date Posted: 07/06/2017
Requisition Number: hrq-76833

Job Details

  • Job Purpose: • Manages the development, implementation and oversight of key Preferred Provider Partnerships, Community Partnerships and Vendors 1. Assists Sr. Director and SVP of ACO in the development of Preferred Provider Partnerships, Community Partnerships and other Vendor Relationships via identification of CHA Network needs and/or communication with related clinical or operational departments 2. Assesses and negotiates various preferred provider relationships as needed 3. Facilitates the execution of the appropriate contracting documents and supports payor contracting efforts as needed and requested 4. Supports the implementation of new Preferred Partnerships, Community Partnerships and Vendor Relationships (MSO credentialing, EHR and system interfaces and other systems access) 5. Verifies on-going system configuration with internal and external responsible parties to ensure current recognition of external preferred partnerships and vendor status 6. Interfaces with internal/external key stakeholders to ensure successful relationship management 7. Coordinates with key functional areas to create and distribute all necessary Education & Communication materials 8. Develops performance reporting for these relationships and ensures underlying systems are addresses to manage and report performance accordingly. 9. Provides oversight of and ensures assigned Preferred Partners and Vendors meet defined service requirements by tracking, measuring, reporting and evaluating vendor performance including financial, quality and utilization management 10. Ensures ongoing and annual performance evaluation of preferred relationships are conducted in a timely and efficiently 11. Manages data and analytics needed to support partner relationships. 12. Interfaces effectively with key internal functional areas to ensure data is timely and accurate 13. Anticipates and troubleshoots all Preferred Partners, Community Partners and Vendor non-compliance

    Qualifications/Requirements • Education/Training: o Bachelor's degree in Business Administration, Health Administration or Public Health; Master's Degree Preferred • Licensure: Certifications: o Project Management Certification • Preferred Work Experience: o Minimum of Seven (7) years' experience with a managed care organization, health system and/or ACO o Health system or a health care related organization (HMO; Medicaid; Medicare) o Demonstrated knowledge and experience in one or many of the following areas preferred: ? ACO management, service delivery coordination, contract negotiation and compliance, financial compliance and vendor oversight o Demonstrated experience with managing and cultivating strong business relationships o Ability to lead workgroups and manage process in a cross-functional environment Intermediate to Advanced skills in Microsoft Office (Word, Excel, PowerPoint) o Ability to manage multiple projects simultaneously o Ability to manage data and processes in multiple platforms Demonstrated organization, facilitation, presentation and training skills including strong attention to detail Excellent communication skills (written and verbal) S o Strong analytical, critical reasoning and organizational skills


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