Manager of Provider Network Teams

Partnership HealthPlan of California•Redding, CA

3d•$103,060 - $133,978

About The Position

Manage day to day operations; provide leadership, support, and direction to the Provider Performance Oversight and Network Education and Training staff. Ensure the highest level of provider education, training, and oversight to ensure the network stays informed regarding policies and procedures, DHCS All Plan Letters and other State and Federal regulations. Monitor provider performance and identify opportunities for improvement. Monitor established goals and meet deadlines. Retain provider network through excellent customer service and education.

Requirements

Bachelor’s Degree in Healthcare, Marketing, Public Relations, or related fields, minimum three (3) years in healthcare, marketing, or public relations in a managed care environment; or equivalent combination of education and experience.
Ability to disseminate Medi-Cal policies and managed care concepts.
Knowledge of business software applications.
Knowledge of managed care concepts, policies, and procedures.
Valid California driver’s license and proof of current automobile insurance compliant with Partnership policy are required to operate a vehicle and travel for company business.
Excellent oral and written communications skills.
Excellent organization skills with the ability to prioritize assignments, maintain accurate records, and meet deadlines.
Ability to use good judgment in making decisions and handle sensitive issues with tact and diplomacy.
Ability to use a computer and video conferencing equipment and create PowerPoint presentations.
When required, ability to lift, carry, or move objects of varying sizes, weighing up to 30 pounds.

Responsibilities

Manage daily operations of Network Education and Training and Provider Performance Oversight teams
Provide direction, support, and supervision to staff
Responsible for all provider education and training programs and oversight activities
Develop provider education materials
Create provider bulletins and newsletter articles
Establish and monitor corrective action plans
Enhance use of webinars, video conferencing, new technology for provider education
Conduct public meetings as facilitator or educator, requires excellent public speaking skills
Oversight and participate in provider education/training sessions
Establish goals, monitor activities and ensure timelines/goals are met
Conduct targeted provider education based on reports and monitor effectiveness of trainings
Liaison to Claims department/claims resolution staff for provider issues
Liaison to Health Services department
Assist with resolution of provider complaints/appeals/issues
Establish strong working relationships with key provider billing and authorization staff
Develop agenda topics and oversee Provider Education and Networking meetings
Accompany Representatives from PR, Claims, and Health Services on Hospital/Large Group Operations/Service meetings.
Review Partnership educational materials and content. Meet with internal Partnership staff prior to provider meeting to ensure accuracy. Facilitate, lead the meetings.
Provide performance feedback and counseling to staff
Provide staff development and education.
Conduct annual performance reviews.
Act as back up to other Provider Relations department Managers, Associate Director and Director when needed.