Ewings Associates, Inc. Tricare Network Development Manager in Greensboro, North Carolina

Reference # :15-00395Title :Tricare Network Development ManagerLocation :Greensboro, NCPosition Type :ContractExperience Level :1 YearsStart Date / End Date :03/01/2016 / 03/01/2017 Description

Tricare Network Development ConsultantNegotiate contracts with healthcare providers that will service our nation’s military (Tricare) working for the largest US health insurer. EWINGS has been selected by the largest health insurer in the country to provide Network Development professionals in advance of the upcoming Tricare East (Military Healthcare) contracts. This is a chance to contribute to the development of one of the largest healthcare networks ever built - for a very special group of patients; our military and their families.Tricare Network Development positions are temporary (12+ mos.) however, an estimated 20%-30% of the contractors could eventually be offered full-time employment. The projected start date is Monday April 4, 2016. Please provide hourly compensation expectations. Telecommuting is not an option. All contractors will work out of one of our client’s office locations. There will be no travel required. Positions are contingent on our client winning the Tricare East award which will be announced by the Department of Defense of Friday, April 1.Tricare Network Development Position Description:

  • Develop a Tricare provider network with physicians, hospitals, pharmacies, and ancillary groups that is competitive and provides broad healthcare access to patients.

  • Build a stable Tricare provider network that achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product.

  • Evaluate and negotiate Tricare contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls.

  • Establish and maintain relationships with healthcare providers, and ensure the Tricare network composition includes an appropriate distribution of provider specialties.

  • Provide explanations and interpretations within your area of expertise.

  • Use data and facts to identify and solve Tricare network related problems and develop strategies within your area of expertise.

  • Investigate non-standard network requests and manage a wide range of provider Tricare network issues

Qualification Requirements:

  • Undergraduate degree or experience equivalent

  • Minimum requirement is for 3 years of experience in a healthcare network development, network contracting, account management, provider services, provider contracting, etc. There will be considerable opportunities for highly experienced network development professionals as well.

  • In-depth knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS).

  • 2+ years of experience in network fee schedule development using actuarial models.

  • 2+ years of experience utilizing financial models and analysis in negotiating network rates.

  • Intermediate level of knowledge of claims processing systems and guidelines.

  • 2+ years of experience in performing network adequacy and network gap analysis.

  • Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others.

  • Strong interpersonal skills, establishing rapport and working well with others.

Tricare Network Development Position Locations:

  • Birmingham AL 35242

  • Little Rock AR 72201

  • Phoenix AZ 85004

  • Tucson AZ 85711

  • Cypress CA 90630

  • Concord CA 94520

  • Sacramento CA 95826

  • Centennial CO 80111

  • Hartford CT 06103

  • Shelton CT 06611

  • Jacksonville FL 32256

  • Maitland FL 32751

  • Miramar FL 33027

  • Tampa FL 33634

  • Norcross GA 30092

  • West Des Moines IA 50266

  • Meridian ID 83642

  • Chicago IL 60601

  • Indianapolis IN 46278

  • Lexington KY 40503

  • Metairie LA 70002

  • Waltham MA 02451

  • Columbia MD 21045

  • Southfield MI 48034

  • Portage MI 49002

  • Maryland Heights MO 63043

  • Helena MT 59601

  • Morrisville NC 27560

  • Charlotte NC 28209

  • Greensboro NC 27455

  • Morrisville NC 27560

  • Charlotte NC 28209

  • Greensboro NC 27455

  • Omaha NE 68164-9672

  • Iselin NJ 08830

  • Albuquerque NM 87113

  • Las Vegas NV 89128

  • East Syracuse NY 13057

  • Islandia NY 11749

  • Kingston NY 12401

  • Cincinnati OH 45242

  • Westerville OH 43082

  • Cleveland OH 44114

  • Tulsa OK 74133

  • Lake Oswego OR 97035

  • Philadelphia PA 19107

  • Pittsburgh PA 15221

  • Warwick RI 02886

  • Columbia SC 29210

  • Brentwood TN 37027

  • Kingsport TN 37660

  • Knoxville TN 37922

  • Memphis TN 38115

  • Austin TX 78746

  • Houston TX 77027

  • Richardson TX 75080

  • Salt Lake City UT 84120

  • Richmond VA 23235

  • Reston VA 20191

  • Seattle WA 98101

  • Wauwatosa WI 53226