Provider Relations Manager (Remote - must be local to Idaho)
at Magellan Health
Boise, ID 83702, USA -
Start Date | Expiry Date | Salary | Posted On | Experience | Skills | Telecommute | Sponsor Visa |
---|---|---|---|---|---|---|---|
Immediate | 23 Jan, 2025 | USD 64285 Annual | 24 Oct, 2024 | N/A | Good communication skills | No | No |
Required Visa Status:
Citizen | GC |
US Citizen | Student Visa |
H1B | CPT |
OPT | H4 Spouse of H1B |
GC Green Card |
Employment Type:
Full Time | Part Time |
Permanent | Independent - 1099 |
Contract – W2 | C2H Independent |
C2H W2 | Contract – Corp 2 Corp |
Contract to Hire – Corp 2 Corp |
Description:
Remote - must be local to Idaho
Manages the relationships with key health plans and provider networks for the purpose of implementing the company`s cost saving products into large markets nationally. Works daily to improve the relationships with health plan partners and resolves any outstanding issues that may develop. Increases the product for each health plan partner, and seeks medical cost saving programs for all members in the market. Enhances any process or procedure to best serve the Provider Network, and allows our program to be successful. Reports any high level issues for timely resolution and satisfaction.
- Assumes role in researching provider complaints and issues, collaborates with staff from various internal operations areas to determine root causes. Remedies problems, being on point to communicate with providers throughout the course of problem resolution.
- Takes the front-line in establishing and maintaining strong communications with providers. Collaborates with Regional Managers and manages staff and support activities.
- Develops and maintains strategic and tactical approaches to relating to high-impact providers in the network that will distinguish the company in the industry and result in peak provider satisfaction and network stability.
- Establishes and maintains optimal communication channels with client provider relations and account management to foster confidence in the company`s abilities to rapidly resolve provider issues.
- Identifies opportunities for promoting broader use of web services and proactively communicates with providers not taking full advantage of these services to understand why.
- Assists with network strategy committee meeting and network application processing decision committees
- Collaborates and monitors with credentialing teams to ensure provider compliance with provider and state contracts.
- Conducts training sessions for staff: provider relations and call center staff on contract and network management processing and policy in provider and contract management source systems.
WORK EXPERIENCE - REQUIRED
Network, Provider Relations
EDUCATION - REQUIRED
A Combination of Education and Work Experience May Be Considered., Bachelor’s
EDUCATION - PREFERRED
Master’s
Responsibilities:
RESPONSIBILITIES
7+ years’ experience in a Provider Relations role for a managed care plan.
Bachelor’s degree in a related field, or at least 4 additional years of experience in healthcare, network development or network management.
Solid knowledge of health plan operations required.
Knowledge of or experience in management of benefits and/or behavioral health required.
Manages the relationships with key health plans and provider networks for the purpose of implementing the company`s cost saving products into large markets nationally. Works daily to improve the relationships with health plan partners and resolves any outstanding issues that may develop. Increases the product for each health plan partner, and seeks medical cost saving programs for all members in the market. Enhances any process or procedure to best serve the Provider Network, and allows our program to be successful. Reports any high level issues for timely resolution and satisfaction.
- Assumes role in researching provider complaints and issues, collaborates with staff from various internal operations areas to determine root causes. Remedies problems, being on point to communicate with providers throughout the course of problem resolution.
- Takes the front-line in establishing and maintaining strong communications with providers. Collaborates with Regional Managers and manages staff and support activities.
- Develops and maintains strategic and tactical approaches to relating to high-impact providers in the network that will distinguish the company in the industry and result in peak provider satisfaction and network stability.
- Establishes and maintains optimal communication channels with client provider relations and account management to foster confidence in the company`s abilities to rapidly resolve provider issues.
- Identifies opportunities for promoting broader use of web services and proactively communicates with providers not taking full advantage of these services to understand why.
- Assists with network strategy committee meeting and network application processing decision committees
- Collaborates and monitors with credentialing teams to ensure provider compliance with provider and state contracts.
- Conducts training sessions for staff: provider relations and call center staff on contract and network management processing and policy in provider and contract management source systems
REQUIREMENT SUMMARY
Min:N/AMax:5.0 year(s)
Other Industry
IT Software - Network Administration / Security
Other
Graduate
Healthcare network development or network management
Proficient
1
Boise, ID 83702, USA