Meridian

  • Manager of PDT

    Job Location US-Remote
    Job ID
    2017-5018
    Category
    Business Development
    Business Line
    CMC Corporate
  • Overview

    Who we are:

     

    Meridian, a WellCare Company, is part of a national network of passionate leaders, achievers, and innovators dedicated to making a difference in the lives of our members, our providers and in the healthcare industry.

     

    We provide government-based health plans (Medicare, Medicaid, and the Health Insurance Marketplace) in Michigan, Illinois, Indiana, and Ohio.  As a part of the WellCare Family of companies, we deliver healthcare excellence to millions of members nationwide.

     

    Our associates work hard, play hard, and give back. Meridian associates enjoy an exceptional experience and culture including special events, company sports teams, potlucks, Bagel Fridays, and volunteer opportunities.

     

    A Day In The Life of a PDT Manager:

    This position will work with all necessary internal and external partners while leading the Performance Delivery Team (PDT) to successfully drive performance improvement for assigned Value Based Provider Group partners.

     

    Responsibilities

                               

    • Provide leadership to the Performance Delivery Team
    • Ensure the overall success of all assigned Value Based Provider Groups
    • Build collaborative relationships with internal and external customers to facilitate process improvement
    • Draft Value Based Provider Group contracts
    • Lead all internal and external Value Based Provider Group contracting discussions through contract execution
    • Assist in the development of an annual Value Based Provider Group prospective partner list
    • Assist in the development of new Value Based Program models to meet business needs
    • Ensure all Value Based Program reporting is being delivered to assigned Value Based Provider Groups
    • Develop and execute Value Based Provider Group business plans
    • Lead all internal and external Business Planning and Core Team meetings
    • Ensures all Value Based Program contract requirements are achieved
    • Ensure all internal implementation plans for assigned Value Based Provider Groups are executed timely
    • Lead the gathering of all necessary submission data for PDT and corporate NSP team
    • Work in accordance with corporate NSP team to develop and improve departmental processes and procedures
    • Assist in identifying and analyzing requests for proposals and assist in successful responses for Meridian Health Plan, Meridian Advantage and MeridianRx
    • Assist in Prospecting and generating leads of potential providers

     

    • Assure compliance with requirements of all national and State regulatory agencies, including NCQA, URAC, CMS or general accreditation
    • Assist in special projects assigned by the Executive Team
    • Perform other duties as assigned

    Qualifications

    What You Can Bring To Meridian:

     

    Education:

    • Bachelor’s degree or Fellow designation from the Academy for Healthcare Management (AHM) is required

     

    Knowledge & Experience:

    • 5+ years experience in managed health care industry
    • 3+ years experience with Value Based Programs
    • 2+ years experience with health care contracting
    • Thorough knowledge of CMC’s mission and its operational structure
    • Basic knowledge of CMC’s provider policies and procedures
    • Strong knowledge of MS Office, Excel
    • Strong knowledge of medical terminology


    Skills:

    • Excellent organizational skills
    • Excellent project management skills
    • Excellent computer skills
    • Excellent oral and written communication skills
    • Excellent customer service skills
    • Excellent writing and presentation skills

    Abilities:

    • Ability and willingness to travel up to 50% of the time
    • Ability to communicate clearly and concisely both orally and via written documents
    • Ability to work as part of a team while meeting and maintaining individual goals and objectives
    • Leadership capabilities, self-motivation and outstanding ability to sell
    • Computer skills with MS Office, databases, Internet searches, etc.

     

    What Meridian can offer you:

    • Our healthcare benefitsinclude a variety of PPO plans that are effective on the first day of employment for our new full-time team members.
    • Opportunity to work with the industry’s leading technologies and participate in unique projects, demonstrations, conferences, and exclusive learning opportunities.
    • Meridian offers 401k matching thatis above the national average.
    • Full-time MHP employees are eligible for tuition reimbursement towards Bachelor’s or Master’s degrees.
    • Meridian Health Plan was named Detroit's #1 Fastest Growing Companyby Crain's Magazine, so it is a great time to get involved with Meridian. 

     

     

    EQUAL OPPORTUNITY EMPLOYER              

    #MSTR

     

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