Job Details

Director, Network Development - Clinical Background Required

Magellan Health is looking for a Director, Network Development who leads strategy and planning for provider network development, contracting, credentialing and provider communications to ensure network adequacy and member choice of providers.

Responsibilities

• Lead network planning and strategy for implementation or transformation of delivery systems, supporting all network-related activities during new contract implementations.
• Conduct market research for emerging markets and develop capture strategy specific to provider networks, performing SWOT analysis of Tier 1 priority states.
• Act as a Network SME on active proposals, collaborating with national network team to drive solutions, storyboard solutions, and prepare post-RFP content.
• Travel to opportunity markets, facilitate meetings with providers and associations, and produce comprehensive summaries of provider engagement.
• Contribute to comprehensive work plans to understand the network and build a list of all provider types, including training, qualifications, and cost requirements.
• Plan, develop and ensure implementation and positive outcomes of the Annual Network Development Plan, including network adequacy, appointment access, development of resources for unmet needs, contracting with qualified service providers, and compliance with federal and state laws.
• Lead and provide direction to the Magellan Network team across all development responsibilities.
• Lead provider recruitment activities, ensuring compliance with contracting, credentialing, and privileging policies and procedures.
• Ensure the Network Transition Plan is successful meeting all established timeframes.
• Perform other network-related activities as assigned.

Other Job Requirements

• 8+ years of managed healthcare experience.
• Significant experience in progressive network management and development.
• Knowledge of NCQA requirements.

General Information

• Title: Director, Network Development - Clinical Background Required
• Grade: 30
• Work Experience - Required: Network
• Education - Required: Bachelor's (or combination of education and work experience)
• Salary Range: $105,230 - $178,890

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.