Program Management Senior Manager (Military One Source) - Evernorth Behavioral Health - Hybrid

The Military OneSource (MOS) Program Management Senior Manager will have oversight of the Military OneSource network and lead a multi-specialty team in support of MOS.

Responsibilities include but are not limited to reimbursement process and policies, contract solutions, provider relations, data load / management and network performance.

The Manager will supervise a multi-specialty team who is accountable for network maintenance and performance. The Military OneSource Senior Manager will utilize in-depth contracting and network knowledge to mentor the team, identify trends as well as facilitate process improvements to positively impact participant quality of care, access as well as provider experience.

This Senior Manager will collaborate with the other areas of the organization to develop action plans, align with enterprise processes and standards.

Role and Responsibilities

Lead multi-specialty team to ensure network performance and adequacy in accordance with internal and Department of Defense standards.

Utilize internal data such as claims, negotiations and network composition / adequacy to develop a comprehensive network strategy.

Coordinate with multiple matrix partners to develop and monitor the budget for new and existing providers as well as rate increases.

Guide provider partnerships / relationships and education to ensure success of Military OneSource network; meeting customer and provider expectations.

Lead strategic initiatives to monitor Military OneSource network needs, meeting all standards and implementing corrective action plans when necessary.

Identify and / or support provider experience improvement initiatives to increase provider satisfaction and adherence to Military OneSource network requirements.

Create and maintain metrics on Department and Team Monthly Operating Reports (MOR) identifying trend and highlighting successes as well as barriers to success.

Meet regularly with staff to mentor, guide and develop needed skills for their roles as well as assist with complex issues.

Qualifications :

Master’s degree strongly preferred

6+ years of network / contracting experience.

Intimate knowledge of managed care operations (contracting and provider relations) and outpatient network management in behavioral and / or medical with experience with commercial and government products, such as Medicare, Medicaid and or Individual and Family Plans.

Strong strategic acumen, including strategic thought, creation, and execution.

Adept analytical, project management skill, superior problem solving and decision-making skills.

Excellent management and leadership skills.

Enterprise thinker with proven ability to influence across a matrix environment.

Ability to develop relationships across all levels of the organization, as well as externally.

Technical / Functional expertise : provider contracting, provider relations, negotiation, metric management, corrective action implementation and monitoring.

Exceptional service experience knowledge and skills.

Proficient writing and verbal communication skills and experience with formal presentations.

Capable of working independently and be self-directed.

Skilled in Project management