Magellan Health

Compensation

Full Description

This position is responsible for the development of the provider network, assuring network adequacy and appointment access, development of network resources in response to unmet needs, and adequacy of the provider network to provide member choice of providers, and contracting with qualified service providers in compliance with federal and state laws. This role will lead Magellan's strategy and planning in the successful development of the provider network including network development, contracting, credentialing and provider communications for existing or emerging markets, as assigned. Role is responsible for the annual network development plan as well as key business development activities as assigned. Leads network planning and strategy efforts to support the successful implementation or transformation of the various delivery systems, including assisting in all network related activities during new contract implementations Conducts market research for emerging markets and develops Capture Strategy specific to the provider network - SWOT Analysis of each Tier 1 Priority State specific to the current provider delivery system as applicable. Operates as a Network SME for all active proposals, work with the existing national network team to drive solutions, actively storyboard solutions to identified problems, and assist in preparing content post RFP release. Travel to identified opportunity, facilitating meetings in the market with providers, provider associations etc. and develop comprehensive summaries of all provider engagement as needed Contribute to comprehensive work plans geared towards understanding the Network, building out a comprehensive list of all provider types including training, qualifications, and cost requirements. Plans, develops and ensures implementation and positive outcomes of the Annual Network Development Plan including network adequacy and appointment access, development of network resources in response to unmet needs, contracting with qualified service providers and compliance with Federal and State laws. Leads and provides direction to the Magellan Network team including all development responsibilities. Leads provider recruitment activities and ensures compliance with contracting, credentialing and privileging policies and procedures. Ensures the Network Transition Plan is successful meeting all established timeframes. Other network related activities as assigned. The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description. Other Job Requirements Responsibilities 8+ years managed healthcare experience. Significant experience in progressive network management and development. Knowledge of NCQA requirements. General Job Information Title Director, Network Development - Clinical Background Required Grade 30 Work Experience - Required Network Work Experience - Preferred Education - Required A Combination of Education and Work Experience May Be Considered., Bachelor's Education - Preferred License and Certifications - Required License and Certifications - Preferred Salary Range Salary Minimum: $105,230 Salary Maximum: $178,890 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures. Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive. Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law. Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here. Warning: Employment Scam It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. “Interviews” are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office. Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit. If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911