Alignment Healthcare USA, LLC
Manager, Network Management (Finance)
1. Minimum Experience:
a. Minimum 5-7 years' experience with an HMO, managed care provider organization (IPA, Medical Group or institutional provider) or insurance company with at least 3 years' specific experience in managed care contracting and knowledge or Medicare Advantage regulatory guidelines.
b. Proficient in MS Office, including strong Word and Excel proficiency.
2. Education/Licensure:
a. Bachelor's Degree or equivalent experience required
3. Other:
a. Detail oriented.
b. Language Skills: Ability to read and interpret documents such as contracts, safety rules, operating and maintenance instructions and procedure manuals. Ability to interpret government regulations a must. Ability to write routine reports and correspondence.
c. Ability to speak effectively before groups of providers or employees of internal/external organization.
d. Mathematical Skills: Ability to calculate figures and amounts such as fee schedules, per diem rates, discounts, interest, commissions, proportions, and percentages. Ability to apply concepts of algebra, geometry and statistics.
e. Reasoning Skills: Strong analytic and problem-solving skills required, including ability to synthesize, interpret and apply detailed and complex information.
f. Office Hours: Monday-Friday, 8am to 5pm. Extended work hours, as needed.
g. Maintain reliable means of transportation. If driving, must have a valid driver's license and automobile insurance.
h. Drives approximately 20-40% of the time to provider sites.
4. Work Environment:
a. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
ESSENTIAL PHYSICAL FUNCTIONS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.