Support network pricing strategies and tactics, in collaboration with local network field leaders and network managers Analyze financial impact of provider contracts (e.g., facility; physician; ancillary) Analyze payment appendices to provide options for various contracting approaches and methodologies Communicate results of financial impact and analysis to appropriate st

Assess, plan and implement care management interventions that are individualized for each member and directed toward the most appropriate, least restrictive level of care Identify and initiate referrals for both healthcare and community based services; including but not limited to financial, psychosocial, community and state supportive services Develop and implement care

Leadership (Measured through performance metrics, Colleague Reviews) Overall local market health plan clinical operations for all products including achievement of annual clinical, quality/affordability and utilization management goals Local market SME for all clinical/medical management programs and contractual requirements Lead, coach/develop, trains (in conjunction wit