Job Details

Requisition Number 18-0015
Post Date 2/5/2018
Title Network Manager II
City Austin
State TX


Under general supervision, the Network Manager II is responsible for provider contracting and network development.  This position acts as a resource to regions regarding network development and maintains a positive relationships with the provider network.  

Assists with the development of proposals, negotiating pricing, and developing provider specific reimbursement methodologies. 

Assists providers, including issue research and resolution, education and communication as it relates to contract performance. 

Performs contract reviews to ensure accuracy of provider and reimbursement information and improve provider satisfaction. 

Interfaces with all departments to provide clarification on provider contract issues to ensure the accuracy, consistent application and administration of contracts. 

Performs fee schedule/reimbursement analysis to evaluate cost or savings of new contracts or renegotiation of statewide providers, in addition to providing assistance to regions. 

Assesses, recruits, and organizes provider contracts for all networks. 

Negotiates provider agreements with facilities, laboratories, and group physician practices in adherence with company policies for all lines of business. 

Familiarity with industry standard reimbursement methodologies for Medicare, Medicaid and commercial lines of business.     

Initiates and maintains effective channels of communication with Provider Relations Team in the regions.  

Communicates contracting pricing parameters to the Pricing Configuration Team. 

Coordinates provider status information with member services. 

Performs other duties as required. 




Bachelor’s degree preferred, Experience will be considered in lieu of degree.  

3 years minimum Provider Relations experience. 

2 years previous contracting experience with Physicians, Ancillaries and Hospital systems 

Working knowledge of contract language and reimbursement methodologies.  

FirstCare Health Plans is an Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, genetics or any other basis prohibited by law.


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