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Manager, Provider Network - Medicare

Manager, Provider Network - Medicare

Group 1001Atlanta, GA, US
16 hours ago
Job type
  • Full-time
Job description

Manager, Provider Network Management

Group 1001 is a consumer-centric, technology-driven family of insurance companies on a mission to deliver outstanding value and operational performance by combining financial strength and stability with deep insurance expertise and a can-do culture. Group1001's culture emphasizes the importance of collaboration, communication, core business focus, risk management, and striving for outcomes. This goal extends to how we hire and onboard our most valuable assets our employees.

Clear Spring Health is part of Group One Thousand One ("Group1001"), a customer-centric insurance group whose mission is to make insurance more useful, intuitive and accessible so that everyone feels empowered to achieve financial security. Clear Spring Health is dedicated to helping seniors protect their health and well-being by providing Medicare Advantage plans in select counties of Colorado, Illinois, North Carolina, and Virginia, plus Georgia and South Carolina and offers Medicare Prescription Drug Plans in 42 states plus DC.

The Manager, Provider Network Management, is responsible for overseeing the contracting, provider relations, and performance of the Medicare Advantage provider network. This role ensures that network adequacy, provider satisfaction, and operational integrity meet CMS requirements and organizational standards. The manager will lead a team focused on building strong provider relationships, monitoring performance metrics, and driving strategic initiatives to enhance member access, affordability, and quality of care.

We are primarily seeking candidates who reside in the state of Georgia or Colorado experienced in the Medicare provider network. At Clear Spring Health, our mission is to simplify health to enrich lives. We believe in clarity, compassion, and connection for our members, our providers, and our people. Our culture is built on five action-oriented pillars : Do What's Right, Serve with Humility, Own It, Grow with Intention, and Innovate with Purpose.

How You'll Contribute :

  • Network Development & Contracting
  • Provider Relationship Management
  • Regulatory & Compliance Oversight
  • Performance & Operations
  • Leadership & Collaboration

What We're Looking For :

  • Bachelor's degree in Healthcare Administration, Business, or related field required; Master's degree preferred.
  • Minimum 57 years in provider network management or contracting within a Medicare Advantage or managed care environment.
  • Demonstrated understanding of CMS requirements, risk-based contracting, and provider reimbursement methodologies (FFS, capitation, value-based).
  • Experience leading teams and managing cross-functional projects.
  • Excellent analytical, organizational, and communication abilities.
  • Proficient in Microsoft Office and provider network management tools (e.g., FACETS, HealthEdge, or similar).
  • Strong negotiation and relationship-management skills.
  • Compensation :

    Our compensation reflects the cost of labor across several U.S. geographic markets. The base pay for this position ranges from $100,000 / year in our lowest geographic market up to $135,000 / year in our highest geographic market. Pay is based on a number of factors including market location and may vary depending on job-related knowledge, skills, and experience.

    Benefits Highlights :

    Employees who meet benefit eligibility guidelines and work 30 hours or more weekly, have the ability to enroll in Group 1001's benefits package. Employees (and their families) are eligible to participate in the Company's comprehensive health, dental, and vision insurance plan options. Employees are also eligible for Basic and Supplemental Life Insurance, Short and Long-Term Disability. All employees (regardless of hours worked) have immediate access to the Company's Employee Assistance Program and wellness programsno enrollment is required. Employees may also participate in the Company's 401K plan, with matching contributions by the Company.

    Group 1001, and its affiliated companies, is strongly committed to providing a supportive work environment where employee differences are valued. Diversity is an essential ingredient in making Group 1001 a welcoming place to work and is fundamental in building a high-performance team. Diversity embodies all the differences that make us unique individuals. All employees share the responsibility for maintaining a workplace culture of dignity, respect, understanding and appreciation of individual and group differences.

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    Manager Provider Network • Atlanta, GA, US

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