HMSA Senior Provider Partnership Manager

This position is responsible for building collaborative working relationships with Magellan providers. Responsible to meet with providers on a regular cadence to develop and build collaborative partnerships.

Presents performance and quality metrics with strategic providers and highlight actionable insights to drive measurable provider outcomes.

Serves as the primary point of contact for assigned providers, resolving issues, and providing education & training on the systems and online tools.

Collaborates with internal departments to align and deliver on network goals. Overall goal is to increase provider satisfaction, drive provider quality and performance, and enhance the quality of services provided to Magellan members.

• Establishes strong relationships and engage with inpatient and outpatient providers, forming collaborative partnerships to drive measurable performance and quality improvements (HEDIS).
• Shares performance and quality metrics with providers on a quarterly or as needed basis, provide actionable insights and strategies for improvement.

Meets with providers face to face, via zoom or Teams.

• Devises and implements strategies to drive provider performance and enhance quality in alignment with network, clinical and quality goals.
• Collaborates with Network Contracting team to establish Value Based Payment models with identified providers, oversee and deliver feedback to providers on established VBP metrics quarterly.
• Represents company at client meetings, community events, conferences, and advocacy groups, is the face for provider community.
• Acts as liaison between Clinical, Quality, and Network and the provider community, sharing provider feedback to internal groups, identify best practices and drive innovation.
• Provides education and training to Magellan contracted providers on Magellan systems, policies, requirements, online tools and resources.
• Participates in internal workgroups to provide direction in proactive development, enhancement of quality and performance metrics, provider tools, and resources.
• Provides summary and problem specific feedback, analysis, action recommendations to senior management and relevant functional units regarding provider problems, issues, and general concerns impacting working relationships with providers.
• Collaborates with internal Magellan teams (Clinical, Quality, Network) to implement and drive regional and corporate initiatives.
• Tracks provider meetings & performance and report to leadership as needed.
• Other tasks, workgroups, or reports as assigned

Other Job Requirements

Responsibilities

Bachelor's degree, management or clinical background

Knowledge of managed healthcare principles.

Ability to develop, articulate and communicate strategic plans

Ability to analyze and interpret data and metrics

Demonstrated ability to collaborate with colleagues within and outside department to achieve mutual performance goals.

Excellent communication and leadership skills.

General Job Information

Title

HMSA Senior Provider Partnership Manager

Grade

Work Experience - Required

Healthcare, Managed Healthcare

Work Experience - Preferred

Education - Required

Bachelor's

Education - Preferred

Master's

License and Certifications - Required

License and Certifications - Preferred

Salary Range

Salary Minimum : Salary Maximum :

Salary Maximum :

This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location.

Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.

This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.

Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE / M / F / Vet / Disabled.

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position;

and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.