MANAGER, PROVIDER RELATIONS in Cypress, CA at Beacon Health Options

Date Posted: 3/30/2018

Job Snapshot

Job Description

ABOUT THE POSITION

We are currently seeking a dynamic Manager, Provider Relations to join our team at our office in Cypress, CA.  The Manager, Provider Relations is responsible for oversight of day-to-day operations of the Provider Relations Representatives within the Department; including, but not limited to, daily coordination of work load with staff, performance management, and higher level support and guidance with provider relations issues and/or inquiries. Support and executes provider relations aspects of the provider strategy for existing business as set forth by Corporate Network Management, Regional Operations and Partnerships leadership. Performs provider outreach and proactive personal contact with providers in their offices and through attendance at in-person meetings and professional gatherings.  Provides education and brings provider feedback to the Regional or Corporate Network Management teams for action.  Maintains provider satisfaction and assures network adequacy. Conducts provider office site visits. 

Position Responsibilities:

  • Effectively lead the Provider Relations team as evidenced by provider, internal customer and client satisfaction, compliance with internal, client, regulatory and accreditation standards, successful audits, and employee satisfaction and engagement.

  • Oversee provider relations staff to assure day-to-day activities are performed effectively and support the Region’s network strategy, including meeting financial targets.

  • In collaboration with Network Management Leadership, execute on a process improvement strategy which identifies provider satisfaction impacts and root cause of issues to achieve shorter provider inquiry response times, improved employee engagement, and higher provider satisfaction.

  • Serve as the network escalation point for Regional Leadership on provider relations issues.

  • Assist and support providers to facilitate successful credentialing and recredentialing.

  • Support and participate in the Network Management Department’s process improvement and transformational initiatives to drive completion and successful outcomes.

  • Assure the Provider Relations team is accountable to Network Management Leadership, Corporate Operations, and Regional Teams by meeting internal and external performance standards and guarantees.

  • Develop strong provider relationships built on trust and collaboration. Manage and balance Beacon and provider expectations.

  • Performs practitioner orientation and training of office staff on Beacon policies and procedures and provides updated training throughout the lifecycle of the provider relationship.Coordinates with other internal Beacon departments (e.g. clinical) to ensure key operational areas are aware of any provider re-education or training needs.

  • Collaborate with the Quality and Legal Departments to perform complaint and grievance resolution and communication.

  • Contribute to provider communications such as newsletters, provider manual, mailings, and training.

  • Collaborate with the Network Development team to transition new business to ongoing operations.

  • Act as liaison and maintain productive working relationships with all Beacon departments.

  • Hire, manage and develop a high-performing team.

  • Other duties as assigned.

Position Requirements:

Education: Bachelor’s degree or equivalent experience in a supervisory role required.

Relevant Work Experience:  

  • One to two (1-2) years of supervisory experience

  • Two (2) years of provider relations experience

  • Two (2) years healthcare payor (including managed care) experience preferred

Knowledge, Skills & Abilities:

  • Knowledge of appropriate and professional email correspondence etiquette

  • Strong written and verbal communication skills

  • Strong attention to detail and organizational skills

  • Proficient in the use of Microsoft Office products (Word, Excel, Outlook, PowerPoint, and Access).

  • Knowledge of provider relations responsibilities in a managed care setting.

TO APPLY

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Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled

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