Senior Manager, Provider Relations

About the Role

Leads a team of Provider Relations Representatives, Network Performance Advisors, and/or Provider Relations Supervisors to effectively manage an assigned region and/or market territory. Develops the Provider Relations Team to achieve market performance targets through the implementation and execution of network transformation strategies to improve overall Network Performance.

Responsibilities

• Leads and develops a team of Provider Relations Representatives, Provider Relations Supervisors, and/or Network Performance Advisors.
• Conducts ride-alongs with Reps in the field to develop skills and behaviors and document progress/provide formative feedback through timely and consistent Field Trip Reports.
• Identifies team skill set deficiencies and implements proper professional development plans.
• Monitors Provider Performance action plans and tracks provider performance improvement.
• Ensures compliance with enterprise provider performance and relationship model and team engagement of provider performance reporting.
• Understands the differences between Risk and Value-Based contractual arrangements.
• Understands HEDIS and STARS measures and partners with the Quality Team to drive improvement of quality provider performance.
• Plans, prepares, and executes effective group meetings/discussions with proper objectives and outcomes.
• Ensures adherence to contractual obligations and to regulatory requirements.
• Identifies areas of opportunity to improve Provider Satisfaction and Provider Experience.
• Assists in monitoring and developing High Performing Practices and driving Network Transformation Strategies to optimize member outcomes.
• Educates and enhances provider partnerships and implements market and enterprise initiatives.
• Strategizes membership growth for High Performing Practices and/or sophisticated complex provider relationships.
• Provides training, mentoring, and guidance to new managers.
• Handles special projects as assigned or directed.
• Leads and develops Provider Operations staff.

Requirements

• Bachelor's Degree in a related field.
• 6+ years of experience in provider relations or a similar background.
• 3+ years of management experience.
• Candidates must reside in DE, MD, NJ, or PA.

Pay

$87,700.00 - $157,800.00 per year. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives.

Benefits

• Competitive pay
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• Flexible approach to work with remote, hybrid, field, or office work schedules

Benefits may be subject to program eligibility.