The Network Manager is responsible for supporting and enhancing national provider networks for Gene, Cellular and Innovative Therapies (GCIT®) and Institutes of Excellence (IOE®) transplant services and operations
Serve as a subject matter expert in contract implementation, network operations, managing complex contract data, ensuring accuracy and alignment with organizational goals and supporting provider recruitment and negotiation activities
Involves collaborating across clinical, legal, sales, and network teams to align strategies and improve network performance
Focuses on maintaining high-quality, accessible, and cost-effective networks while tracking and reporting program performance
Plays a key part in expanding access to innovative, life-changing treatments through strong operational execution and cross-functional coordination

5+ years of experience in a health insurance/healthcare environment
2+ years working knowledge of SCM Web Application and familiarity with the documents housed in SCM and Aetna contract systems
3-5 years contract implementation, network operations, negotiation, provider data service, provider relations, and/or claims experience
Strong communication, customer service, critical thinking, problem resolution and interpersonal skills
Proven ability to collaborate cross-functionally to support provider network management initiatives
Demonstrated ability to manage multiple projects simultaneously, work independently as well as in a team environment and cross functionally across the broader organization
General knowledge of provider compensation methods, coding and billing (per diems, case rates, stop loss, revenue codes, DRGs, CPT-4)
Experience in healthcare network management, provider contracting, and managed care reimbursement
Understanding of 340B drug pricing, AWP and WAC drug reimbursement methodologies as well as global bundled contracting arrangements
Strong working knowledge of healthcare business segments, products, and industry terminology
Excellent communication skills, with experience handling complex provider relationships and operational issues
Systems knowledge: Quickbase, Excel, Adobe sign

medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
comprehensive benefits package designed to support physical, emotional, and financial well-being

Manager, Network & Operations

Key skills