Institutional Liaison, Sr

Health Net, Inc. (NYSE: HNT) is among the nation's largest publicly traded managed health care companies. Health Net's mission is to help people be healthy, secure and comfortable. The company's POS, HMO, insured PPO, behavioral health and government contracts subsidiaries provide health benefits to more than 7 million individuals. For more information on Health Net, Inc., please visit the company's Web site at www.healthnet.com



JOB SUMMARY:



The Senior Institutional Liaison is responsible for developing and negotiating contract terms with current and potential participating provider entities. Oversees related duties of the Institutional Liaison staff relative to specific projects. Involvement with internal projects related to network development activities and serve as a resource to other departments regarding contracting initiatives and pricing strategies.



ESSENTIAL DUTIES AND RESPONSIBILITIES:Supports the Director, Provider Contracts/CT in all functions related to network development activities, including negotiation of contract terms, managing-out-of-contract episodes, serving as mediator regarding high profile contract disputes, etc. Serves as an integral member on the Reimbursement Committee and other internal committees as needed. Oversees the development of the institutional Provider Manual by Institutional Liaison staff. Serves as a resource to senior management and other functional areas (Actuarial, Sales, Finance) regarding network development activities, and contracting strategies. Develops and modifies proposed contract language with direction from both Network Management and Legal senior staff. Identifies areas of operational opportunity and defines business processes, roles, and responsibilities regarding interdepartmental relations. Works with Technical Analyst to identify areas of concern as related to financial, utilization, demographic, and other pertinent provider network data. Gathers and analyzes the data to be used in developing recommendations for improvement. Develops all baseline information for contract negotiations including written proposals, internal analyses, competitor information, and regulatory concerns. Manages and cultivates key relationships with several provider, political, and regulatory stakeholders. Develops internal policies and procedures in concert with operational areas to ensure compliance with contractual stipulations. Coordinates affiliate network and network accessing activities with external entities. Serves as business owner regarding the development of automated contract compliance techniques. REQUIREMENTS


REQUIREMENTS:



Education:

Bachelor's Degree in Business Administration, Health Care, or related field is required; Master's degree preferred.



Certification/License:



Experience:

Minimum three years experience in a network management, or health care capacity.

Experience with PC-based software, including relational database and spreadsheet applications.

Knowledge, Skills & Abilities:Strong interpersonal and communications skills are required. Must demonstrate the capacity to effectively manage multiple projects simultaneously that will require strong organizational and project management skills. Ability to effectively and concisely present complex financial, and business relationships to various audiences. Strong writing skills required.

OR
Any combination of academic education, professional training or work experience, which demonstrates the ability to perform the duties of the position.



Health Net, Inc. supports a drug-free work environment and requires pre-employment background and drug screening.



Health Net and its subsidiaries are an Equal opportunity/Affirmative Action Employer M/F/V/D.