Manager - Provider Network Operations

Manager - Provider Network Operations

Presbyterian is seeking a Manager - Provider Network Operations. The person in this position will ensure the integrity of provider service, contracting, development of new networks. Build and maintain strong relationships with providers to foster collaboration and improve communication. Educates providers with current and new protocols, policies, procedures. Provides leadership to the department staff whose focus is education, support, engagement, fostering relationships while recruiting providers. Acts as a key resource in mentoring and education of staff. Responsible for identifying issues, resolving and coordinating resolution of complex disputes or issues. Contributes to the overall optimization of the provider network, ensuring adequate access and coverage for members.

Will manage and coordinate assignments and work productivity of supervised staff. Provides leadership and assistance to Supervisor, Trainer, Provider Executives, Provider Associates of Provider Network Operations. Provides direction and support for ensuring successful execution of contract compliance with Presbyterian Health Plan policy as well as compliance with applicable Medicare, Medicaid, third-party guidelines. Executes Presbyterian Health Plan's network development strategies and initiatives.

• This is a Full Time position - Exempt : Yes
• Job is based at Rev Hugh Cooper Admin Center
• Work hours : Days

The ideal candidate will have :

Join a workplace where compassion meets purpose. Apply today!

Qualifications

Responsibilities

Benefits

Presbyterian offers a comprehensive benefits package to eligible employees, including medical, dental, vision, disability coverage, life insurance, and optional voluntary benefits.

The Employee Wellness Rewards Program encourages staff to engage in health-enhancing activities - like challenges, webinars, and screenings - with opportunities to earn gift cards and other incentives.

AA / EOE / VET / DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

Maximum Offer for this position is up to

USD $52.95 / Hr.

Compensation Disclaimer

The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.