LOCATION : Remote must live in or near Vaya’s catchment area. Incumbent in this role must reside in North Carolina or within 40 miles of the NC border.
GENERAL STATEMENT OF JOB
The Provider Education and Communications Manager’s role is to develop, coordinate, and manage activities related to the communications and trainings of behavioral health, intellectual and / or developmental disability and physical health providers contracting or working with Vaya Health, oversight and management of provider reporting, administration and coordination of the Vaya Provider Advisory Council, management, oversight of provider portal logins, and coordination of provider facing website content .
This role is accountable for the Vaya Provider Support Plan and for building effective communication strategies to assure providers are well informed of Vaya Health business processes and to make sure providers are appropriately trained to deliver the highest quality of care possible to Vaya members and recipients.
This role provides day to day facilitation, oversight / monitoring, and implementation of business processes to the Vaya provider network department and external provider organizations.
Note : This position requires access to and use of confidential healthcare information or protected health information (PHI) as described in laws addressing patient confidentiality, including, but not limited to, the federal HIPAA law, the Confidentiality of Alcohol and Substance Abuse Patient Records law, 42 CFR Part 2, and various state laws.
As such, the individual filling this position shall be required to be trained regarding such laws and shall be required to observe those laws in his / her capacity as an employee of Vaya Health.
The individual filling this position shall also sign a confidentiality statement as an employee of Vaya Health.
ESSENTIAL JOB FUNCTIONS
Provider Training :
- Develop, implement, and coordinate a comprehensive Provider Support Plan that includes training for providers that meets all Tailored Plan, Medicaid Direct, State funded, and Money Follows the Person, and other health plan requirements
- Ensures the develop and implementation of training material to be used with network providers to effectively train network providers on all elements identified in the Provider Training Plan
- Supervises the provider communication and training team in the development and implementation of a comprehensive training plan for network providers.
- Assists other Vaya teams with the development and implementation of the Provider Support Plan to assure a coordinated effort across all Vaya departments
- Manages the oversight of the Vaya Provider Portal, System Access Administer access, and assures providers have access to all required health plan information
- Develops, plans, and implements an annual Provider Summit to provide training and recognition to network providers.
- Manges and implements provider orientation sessions for new network providers
Manages implementation of Provider Communications :
- Develop, implement, and coordinate a comprehensive Provider Communication Plan within the Vaya Provider Support Plan.
- Manages and coordinates all external communications to network providers, inclusive of Provider Communication Bulletins, Provider TouchPoints, Provider Roundtables, Provider Learning Communities, and ad hoc provider meetings.
- Manages the content of the Provider Network Operations (PNO) Website content to assure content is refreshed and accurate for network providers.
Assists the Office of Communication to ensure all provider facing web pages are updated by their content owners.
- Manages and coordinates activities related to the Vaya Provider Advisory Council (PAC) and all subcommittees, inclusive of agenda and minutes development, action item tracking, and issues resolution.
- Assist the PAC leadership in the updating of the Committee Charter and development of PAC membership to be inclusive of all provider types across the Vaya provider network.
- Provides administration and management of the PAC website platform, MyCommittee .
Assists with implementation and coordination of external provider projects Network Operations :
- Manage completion and implementation of the Vaya Cultural Competency Plan
- Assists in the development of presentations for conferences, provider forums, and Board of Directors.
- Attends and represents Vaya on State, local, and internal committees and workgroups as assigned
- Assist with the updating of the PNO sections of the Provider Operations Manual
- Manage the collection, analysis, and coordination of provider reports to meet required deadlines and drive process improvement
- Manages special projects for Provider Network
- Supports Provider Network departments quality improvement projects
- Assists with end-to-end processes creating, controlling, and improving business processes
- Provides support and coordination for National Accreditation, State and local reviews of Provider Network department roles and duties
- Conducts Process Mapping of Provider Network department activities
- Assists with Business Process Improvement
- Supports the implementation of Value Based performance measurement within the provider network.
- Assists in the development and implementation of a provider quality measurement tool
- Conducts quality reporting, analysis, and audits for developing plans and programs to support continuous quality improvement using applicable tools.
Provider Portal Login Management :
- Manages the end-to-end process for issuing and managing all System Access Administer Provider Log Ins for the Vaya Provider Portal.
- Assists with the resolution of Provider Portal tickets and issues.
- Participates with the Portal Steering Committee around the development and implementation of all new Provider Portal enhancements.
- Manages all Announcements posted to the Provider Portal
- Ensures Provider Portal job aids are posted and available for providers to navigate the Provider Portal
- Maintains links and resources available to providers on the Provider Portal Resource Page.
KNOWLEDGE, SKILL & ABILITIES
- Knowledge of the assessment and treatment of mental health, developmental disabilities, and substance use disorder, sometimes co-occurring
- High level of knowledge of Microsoft Office applications and adept at learning software applications expert level preferred
- Highly motivated, team player, self-starter and able to work independently with little or no direction
- Ability to exercise discretion and make independent decisions without supervisory input on matters of significance
- Proficiency in analyzing, understanding, and communicating network needs
- Strong customer service skills paired with a positive demeanor a can do attitude
- Excellent verbal and technical writing skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others, including but not limited to reimbursement policy standards.
Ability to write technical documents based on an established style and communication guide.
- Exceptional business acumen
- Ability to present to varied audiences on various disability topics
- Ability to manage multiple priorities in a fast-paced environment
- Prior demonstrated success in provider relations or relations with both large provider groups and / or ancillary providers
QUALIFICATIONS & EDUCATION REQUIREMENTS
Bachelor’s degree and 2-5 years of relevant training, communications or provider relations experience required. Master’s degree preferred.
Preferred Experience :
5+ years of experience in a network management-related role handling complex network providers in the health care industry with accountability for business results preferred.
PHYSICAL REQUIREMENTS
- Close visual acuity to perform activities such as preparation and analysis of documents; viewing a computer terminal; and extensive reading.
- Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists and fingers.
- Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time.
- Mental concentration is required in all aspects of work.
RESIDENCY REQUIREMENT : This position is required to reside in North Carolina or within 40 miles of the North Carolina border.
SALARY : Depending on qualifications & experience of candidate. This position is exempt and is not eligible for overtime compensation.