Network Manager - Little Rock, AR

POSITION SUMMARY 

The Network Manager is responsible for identifying and establishing relationships with high-quality providers, i.e., hospitals, specialists, home health care agencies, etc., to build Sage Health's value-based specialty network within our contracted health plan networks. Additionally, the network manager will support the referral process and post-acute services. The Network Manager will also deliver medical cost performance targets in partnership with center and market leadership. 

PRIMARY RESPONSIBILITIES:  

• Ensure patient information remains secure and confidential.  
• Maintains a safe, secure, and healthy work environment by following Sage Health policy and procedures and complying with legal regulations.  
• Build productive relationships within all departments in the Health Plan, i.e., Provider Relations, Network, Hospital Service, Contracting, HEDIS/Quality, etc. 
• Establishes a value-based, high-quality network of providers, i.e., specialists, hospitals, DME, Home Health Care, etc., on the contracted Health Plans network. 
• Influence Health Plan to add specialists to their network based on cost-effectiveness and quality. 
• Develops strategic and contractual relationships in the market with hospitals and specialists.  
• Evaluates recruits its onsite specialist as needed and prepare contract and terms i.e., independent contractor or employment. 
• Responsible for the recruitment, interview, hire, training, and performance evaluation of direct reports i.e., Referral Manager, etc. 
• Partners with the center and market leadership in the interview and selection of clinical and non-clinical staff i.e., Referral Manager, Referral Coordinator, Primary Care Physicians, etc. 
• Develops and implements policies, procedures, and work standards and monitors adherence. 
• Responsible for achieving medical cost targets and partners with corporate analytics, Chief Medical Officer, or designee to identify opportunities for improvement. 
• Implement or recommend disciplinary action as needed in conjunction with Human Resources. Document all disciplinary action.  
• Ensures each center within the market has access to electronic health records, hospitals, imaging centers, skilled nursing facilities, etc. 
• Holds regular cadence of meetings and communications with the following: referrals, physician, post-acute, and operations leadership. 
• Identifies additional services that will drive value-based care for our members. 
• Perform other duties as assigned. 

 REQUIRED QUALIFICATIONS:  

• 4-year college degree 
• Managed care experience, i.e., Medicare HMO, D-SNP 
• Knowledgeable of reimbursement methodologies: in hospital, DME, and outpatient settings. 
• Knowledge of health care issues and a variety of facilities, hospitals, or physician offices 
• procedures, concepts, and practices. 
• Minimum eight (8) years of managed care operations experience in a Health Plan, Hospital or 
• Medical Group setting. 
• Minimum five (5) years of people management experience 
• Excellent interpersonal, written, presentation, and verbal communication skills. 
• Experience running reports and analyzing data 
• Ability to develop strong relationships 
• Experience working with payors, inpatient (hospitals), physician groups, and outpatient facilities (skilled nursing facilities). 
• Must be organized and attentive to detail.  
• Ability to manage competing priorities. 
• Ability to work in a fast-paced environment 
• Resourcefulness in problem-solving. 
• Ability to influence. 
• Able to take and follow through with assigned tasks and accountability. 
• Experience working with an electronic health record. 
• Experience with Microsoft Office Word, PowerPoint, Outlook, and Excel. 
• Experienced working in medically underserved/culturally diverse communities. 
• Must be willing to travel to centers within the market or other locations, i.e., new markets or corporate. 
• Complete COVID-19 vaccination (including boosters) is essential to this role. Candidates in states that mandate COVID-19 booster doses must also comply with those state requirements.  

PREFERRED QUALIFICATIONS:  

• Masters' Degree in Public Health, Healthcare Administration, or other related fields
• Knowledge of HEDIS/STARS  
• Knowledge of CAHPS
• Experienced in motivational interviewing  

Reports To:  Operations Director

Sage Health will adhere to all federal, state, and local regulations and client requirements. It will obtain necessary proof of vaccination and boosters, when applicable, before employment to ensure compliance.

ABOUT SAGE HEALTH

We believe all seniors, regardless of means, deserve concierge primary care & wellness without the concierge fee; they've earned it. 

Sage Health builds enriching neighborhood health centers that are easy to access, provide or arrange for all patient's healthcare needs, and partner with Medicare Advantage plans that fully cover primary care. Unlike other physician practices, a Sage Health physician has a patient panel of 400 or less, and we collaborate with the best outcomes-oriented specialists and hospitals in each market. Because we are not a fee-for-service provider and manage patients within a global capitation budget provided by Medicare Advantage plans, our only concern and motivation are to keep our seniors healthy. 

Sage Health is a destination for the best risk provider talent in the country who are building the new standard-bearing senior model for the United States.

Salary : $67,200 - $100,800