Manager Health Plans Provider Relations - HP Network

Description

Summary :

The Manager Health Plans Provider Relations leads the Health Plan Network Services team. The Manager ensures relationships with the providers in the network that the team members in the field manage. The Manager will partner with the Health Plan Network Director and other stakeholders to ensure the team is onboarding, educating, and delivering service to the provider-contracted network effectively and timely to ensure services meet standards. Manages the daily work and deliverables due by the team.

Responsibilities :

Meets expectations of the applicable OneCHRISTUS Competencies : Leader of Self, Leader of Others, or Leader of Leaders.

Train all team members on the processes and policies for the Network.

Offer continuing education to the entire team at least twice a year.

Implement reporting standards to ensure consistent recording of data and ensure compliance.

Serve as the point of contact for escalated issues with network providers.

Facilitate a team environment of growth and development for all team members.

Develop and maintain collaborative relationships with internal stakeholders.

Ability to review, manage, and maintain the processes and procedures.

Manage provider engagement / risk continuum, evaluating potential providers for value-based opportunities.

Apply network configuration and incentive-based payment models, as appropriate, to improve quality and efficiency.

Leverage financial and utilization data with physicians and healthcare executives to provide actionable goals and opportunities to reduce expenses for providers with shared savings.

Responsible for reporting team activities, production, and project completions.

Oversee Kyrus's reporting as related to the Physician Services team activities.

Manage monthly 1 : 1 meetings with each team member.

Excellent communication and presentation skills.

Ability to travel occasionally for meetings, team support, and project oversight.

Job Requirements : Education / Skills

Bachelor's degree in a related field is required.

Proficient in Microsoft Word, PowerPoint, and Excel.

Analytic ability to organize and prioritize work.

Experience

5 years experience in the provider-facing healthcare field.

3 Years experience in Reporting outcomes and trends.

2 years experience working with Medicare and Commercial Payers.

Experience with ACO, Risk-Based, Value-Based Contracting preferred.

Licenses, Registrations, or Certifications

None

Work Schedule : 5 Days - 8 Hours

Work Type : Full Time

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