Manager Health Plans Provider Relations - HP Network Development

CHRISTUS Health • Irving, TX

2d

About The Position

The Manager Health Plans Provider Relations leads the Health Plan Network Services team and manages relationships with providers in the network. In partnership with the Health Plan Network Director and other stakeholders, this role ensures the team effectively and promptly onboards, educates, and provides service to the contracted provider network in accordance with standards. The Manager oversees the team’s daily work and deliverables, supports team development, and manages provider engagement and value-based opportunities.

Requirements

• Bachelor's degree in a related field.
• Proficiency in Microsoft Word, PowerPoint, and Excel.
• Analytic ability to organize and prioritize work.
• 5 years of experience in the provider-facing healthcare field.
• 3 years of experience reporting outcomes and trends.
• 2 years of experience working with Medicare and Commercial Payers.
• Excellent communication and presentation skills.

Nice To Haves

• Experience with ACO, risk-based, or value-based contracting.

Responsibilities

• Meet expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Train team members on Network processes and policies, and provide continuing education to the entire team at least twice a year.
• Implement reporting standards to ensure consistent data recording and compliance.
• Serve as the point of contact for escalated issues with network providers.
• Foster growth and development for team members and maintain collaborative relationships with internal stakeholders.
• Review, manage, and maintain processes and procedures.
• Manage the provider engagement and risk continuum, evaluating potential providers for value-based opportunities.
• Apply network configuration and incentive-based payment models, as appropriate, to improve quality and efficiency.
• Use financial and utilization data with physicians and healthcare executives to set actionable goals and identify opportunities to reduce expenses for providers with shared savings.
• Report team activities, production, and project completions.
• Oversee Kyrus reporting related to Physician Services team activities.
• Conduct monthly one-on-one meetings with each team member.
• Travel occasionally for meetings, team support, and project oversight.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager