Provider Relations Manager- REMOTE
About the position
The Provider Relations Manager is responsible for managing relationships with key health plans and provider networks to implement cost-saving products on a national scale. This role focuses on improving partnerships with health plan partners, resolving issues, and enhancing processes to ensure the success of the Provider Network. The manager will also conduct research on provider complaints, maintain communication with providers, and collaborate with various teams to ensure compliance and satisfaction.
Responsibilities
Manage relationships with key health plans and provider networks.
,
Resolve outstanding issues with health plan partners.
,
Increase product utilization for each health plan partner.
,
Enhance processes to serve the Provider Network effectively.
,
Research provider complaints and collaborate with internal teams to find root causes.
,
Establish and maintain strong communications with providers.
,
Develop strategic approaches to engage high-impact providers.
,
Maintain communication channels with client provider relations and account management.
,
Identify opportunities for promoting web services to providers.
,
Assist with network strategy committee meetings and application processing committees.
,
Collaborate with credentialing teams to ensure provider compliance.
,
Conduct training sessions for staff on contract and network management.
Requirements
5-8 years of experience in a Provider Relations role for a managed care plan.
,
Bachelor's degree in a related field or at least 4 additional years of experience in healthcare, network development, or management.
,
Solid knowledge of health plan operations required.
,
Knowledge or experience in management of medical drug benefits, specialty pharmacy, pharmacy benefits management (PBM), behavioral health, or radiology may be required.
Nice-to-haves
Master's degree preferred.
Benefits
Competitive salary range of $60,800.00 - $97,280.00 based on experience and skills.
,
Diverse and inclusive work environment.
,
Opportunities for career advancement.
,
Employee involvement and empowerment in decision-making.
,
Recognition and rewards for achievements.
Apply Now
The Provider Relations Manager is responsible for managing relationships with key health plans and provider networks to implement cost-saving products on a national scale. This role focuses on improving partnerships with health plan partners, resolving issues, and enhancing processes to ensure the success of the Provider Network. The manager will also conduct research on provider complaints, maintain communication with providers, and collaborate with various teams to ensure compliance and satisfaction.
Responsibilities
Manage relationships with key health plans and provider networks.
,
Resolve outstanding issues with health plan partners.
,
Increase product utilization for each health plan partner.
,
Enhance processes to serve the Provider Network effectively.
,
Research provider complaints and collaborate with internal teams to find root causes.
,
Establish and maintain strong communications with providers.
,
Develop strategic approaches to engage high-impact providers.
,
Maintain communication channels with client provider relations and account management.
,
Identify opportunities for promoting web services to providers.
,
Assist with network strategy committee meetings and application processing committees.
,
Collaborate with credentialing teams to ensure provider compliance.
,
Conduct training sessions for staff on contract and network management.
Requirements
5-8 years of experience in a Provider Relations role for a managed care plan.
,
Bachelor's degree in a related field or at least 4 additional years of experience in healthcare, network development, or management.
,
Solid knowledge of health plan operations required.
,
Knowledge or experience in management of medical drug benefits, specialty pharmacy, pharmacy benefits management (PBM), behavioral health, or radiology may be required.
Nice-to-haves
Master's degree preferred.
Benefits
Competitive salary range of $60,800.00 - $97,280.00 based on experience and skills.
,
Diverse and inclusive work environment.
,
Opportunities for career advancement.
,
Employee involvement and empowerment in decision-making.
,
Recognition and rewards for achievements.
Apply Now