Manager, Network

Habitat Health

Remote • Remote • Lead • vor 5 Tagen

Healthcare & Medizin Management

<div class="content-intro">At Habitat Health, we envision a world where older adults experience an independent and joyful aging journey in the comfort of their homes, enabled by access to comprehensive health care. Habitat Health provides personalized, coordinated clinical and social care as well as health plan coverage through the Program of All-Inclusive Care for the Elderly (“PACE”) in collaboration with our leading healthcare partners, including Kaiser Permanente.  Habitat Health offers a fully integrated experience that brings more good days and a sense of belonging to participants and their caregivers. We build engaged, fulfilled care teams to deliver personalized care in our centers and in the home. And we support our partners with scalable solutions to meet the health care needs and costs of aging populations.    Habitat Health is growing, and we’re looking for new team members who wish to join our mission of redefining aging in place. To learn more, visit <a href="https://www.habitathealth.com/">https://www.habitathealth.com</a>. </div>Role Scope:  The Network Manager is responsible for the strategic development, execution, and ongoing management of Habitat Health’s provider network across assigned markets and service lines. This role translates organizational network strategy into operational execution while ensuring that the provider network supports comprehensive service delivery, regulatory compliance, and high quality participant care within the PACE model.  The Network Manager oversees provider contracting, provider recruitment, onboarding, and ongoing provider relationship management while ensuring that contracted providers are successfully integrated into Habitat Health’s operational and clinical workflows. This role serves as a senior liaison between Habitat Health leadership, center operations, and external provider organizations and is responsible for ensuring that contractual terms, regulatory expectations, billing requirements, credentialing standards, and care coordination processes are consistently implemented across the network.    In addition to direct provider engagement, the Network Manager is responsible for overseeing network adequacy planning, supporting market expansion initiatives, guiding complex contract negotiations, and managing internal network development processes. The role may also provide supervision and guidance to network specialists or analysts responsible for supporting contracting and provider operations. Drafting, negotiating, and managing provider contracts, amendments, single case agreements, and letters of agreement for traditional and non-traditional providers required to support a comprehensive PACE network.  <ul> <li data-leveltext="" data-font="Symbol" data-listid="4" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="1" data-aria-level="1">Lead the development and execution of network strategy within assigned markets to ensure a comprehensive, compliant, and accessible provider network that supports the full scope of PACE services. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="4" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="2" data-aria-level="1">Identify network gaps, service capacity needs, and strategic provider partnerships based on participant utilization patterns, geographic access requirements, regulatory standards, and program growth projections. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="4" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="3" data-aria-level="1">Lead complex provider contracting negotiations and oversee the development of provider agreements, amendments, letters of agreement, and single case agreements for both traditional and non traditional providers. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="4" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="4" data-aria-level="1">Establish and maintain strategic provider relationships with key health systems, specialty providers, community based organizations, and ancillary service partners required to support comprehensive PACE care delivery. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="4" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="5" data-aria-level="1">Oversee provider recruitment efforts across critical service areas including specialty physician services, behavioral health, home based care, transportation, durable medical equipment, dialysis, infusion, dental, and other essential services. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="4" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="6" data-aria-level="1">Direct provider onboarding and integration activities to ensure providers understand the PACE model, authorization workflows, billing requirements, claims submission processes, and interdisciplinary care coordination expectations. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="4" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="7" data-aria-level="1">Serve as a senior escalation point for provider operational issues including claims disputes, contract interpretation, service delivery concerns, credentialing requirements, and participant care coordination challenges. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="4" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="8" data-aria-level="1">Monitor provider network performance and compliance with contractual obligations and regulatory standards and implement corrective actions or performance improvement strategies when needed. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="4" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="9" data-aria-level="1">Maintain oversight of provider and contract tracking tools to ensure accurate documentation, reporting, and regulatory readiness. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="4" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="10" data-aria-level="1">Support cross functional collaboration with clinical operations, finance, credentialing, compliance, and center leadership to ensure alignment between network development, operational workflows, and participant care delivery. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="4" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="11" data-aria-level="1">Support new market launches and expansion initiatives through proactive provider recruitment, contracting strategy development, and establishment of foundational network partnerships. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="4" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="12" data-aria-level="1">Provide guidance, mentorship, and operational oversight to network specialists or other team members supporting contracting and provider relations activities. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="4" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="13" data-aria-level="1">Identify opportunities to improve network development processes, contracting efficiency, provider onboarding, and operational integration across markets. </li> </ul> Qualifications  <ul> <li data-leveltext="" data-font="Symbol" data-listid="5" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="1" data-aria-level="1">Bachelor’s degree in healthcare administration, business administration, public health, or a related field required. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="5" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="2" data-aria-level="1">Master’s degree in healthcare administration, public health, business administration, or related discipline preferred. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="5" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="3" data-aria-level="1">Minimum 6 to 8 years of experience in provider contracting, network development, managed care, or health plan operations. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="5" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="4" data-aria-level="1">Demonstrated experience leading healthcare provider contract negotiations and managing provider networks within a managed care, integrated delivery, or value based care environment. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="5" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="5" data-aria-level="1">Strong understanding of Medicare and Medicaid reimbursement methodologies, provider billing practices, and managed care contracting structures. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="5" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="6" data-aria-level="1">Experience developing and managing provider networks that support multi service care delivery models. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="5" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="7" data-aria-level="1">Working knowledge of regulatory and compliance requirements related to provider participation within Medicare or Medicaid programs. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="5" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="8" data-aria-level="1">Proven ability to manage multiple provider relationships, contracts, and operational priorities across complex healthcare markets. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="5" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="9" data-aria-level="1">Strong written and verbal communication skills with the ability to translate contractual and regulatory requirements into operational guidance. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="5" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="10" data-aria-level="1">Demonstrated ability to build and maintain strategic relationships with health system leaders, community providers, and internal stakeholders. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="5" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="11" data-aria-level="1">Strong analytical and organizational skills with proficiency in Microsoft Excel, Word, and provider network management tools. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="5" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="12" data-aria-level="1">Ability to operate effectively in a rapidly growing organization and lead initiatives within evolving operational environments. </li> </ul> Nice to have:  <ul> <li data-leveltext="" data-font="Symbol" data-listid="3" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="1" data-aria-level="1">Prior experience working in a PACE program or with PACE providers. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="3" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="2" data-aria-level="1">Experience with nontraditional provider types such as home and community based services, transportation, DME, dental, behavioral health, dialysis, or infusion services. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="3" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="3" data-aria-level="1">Familiarity with delegated credentialing models and credentialing documentation requirements. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="3" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="4" data-aria-level="1">Experience supporting claims issue resolution or billing education for providers. </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="3" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="5" data-aria-level="1">Exposure to network adequacy reporting or provider directory management. </li> </ul> Compensation:   We take into account an individual’s qualifications, skillset, and experience in determining final salary. This role is eligible for medical/dental/vision insurance, short and long-term disability, life insurance, flexible spending accounts, 401(k) savings, paid time off, and company-paid holidays. The expected salary range for this position is $106,000 - $121,000. The actual offer will be at the company’s sole discretion and determined by relevant business considerations, including the final candidate’s qualifications, years of experience, skillset, and geographic location.  Vaccination Policy, including COVID-19  At Habitat Health, we aim to provide safe and high-quality care to our participants. To achieve this, please note that we have vaccination policies to keep both our team members and participants safe. For covid and flu, we require either proof of vaccination or declination form and required masking while in participant locations as a safe as an essential requirement of this role.  Requests for reasonable accommodations due to an applicant’s disability or sincerely held religious beliefs will be considered and may be granted based upon review. We also require that team members adhere to all infection control, PPE standards and vaccination requirements related to specific roles and locations as a condition of employment.   Our Commitment to Diversity, Equity, and Inclusion:  Habitat Health is an Equal Opportunity employer and is committed to creating a diverse and inclusive workplace. Habitat Health applicants are considered solely based on their qualifications, without regard to race, color, religion, creed, sex, gender (including pregnancy, childbirth, breastfeeding or related medical conditions), gender identity, gender expression, sexual orientation, marital status, military or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), or other status protected by applicable law.  Habitat Health is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Habitat Health will take steps to provide people with disabilities and sincerely held religious beliefs with reasonable accommodations in accordance with applicable law.  Accordingly, if you require a reasonable accommodation to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact us at careers@habitathealth.com.  Beware of Scams and Fraud  Please ensure your application is being submitted through a Habitat Health sponsored site only. Our emails will come from @habitathealth.com email addresses. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission by selecting the ‘Rip-offs and Imposter Scams’ option: https://reportfraud.ftc.gov/#/.

Manager, Network

Our South LA team is always hiring!

People Business Partner

Personal Care Attendant – Full Time

Ähnliche Stellen durchsuchen

Weitere Stellen bei Habitat Health

Our South LA team is always hiring!

Outreach & Enrollment Supervisor – South LA

People Business Partner

Personal Care Attendant – Full Time