Manager- Provider Network Operations
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About The Position
Now hiring a Manager- Provider Network Operations. Ensure the integrity of provider service, contracting, and development of new networks. Build and maintain strong relationships with providers to foster collaboration and improve communication. Educates providers with current and new protocols, policies, and procedures. Provides leadership to the department staff whose focus is education, support, engagement, fostering relationships while recruiting providers. Acts as a key resource in mentoring and education of staff. Responsible for identifying issues, resolving and coordinating resolution of complex disputes or issues. Contributes to the overall optimization of the provider network, ensuring adequate access and coverage for members. Manages and coordinates assignments and work productivity of supervised staff. Provides leadership and assistance to Supervisor, Trainer, Provider Executives, and Provider Associates of Provider Network Operations. Provides direction and support for ensuring successful execution of contract compliance with Presbyterian Health Plan policy as well as compliance with applicable Medicare, Medicaid and other third-party guidelines. Executes Presbyterian Health Plans network development strategies and initiatives.
