Manager-Provider Network Operations (Full-time Remote, North Carolina Based)

Alliance Health•Durham, NC

5d•$103,799 - $132,344•Remote

About The Position

The Provider Network Operations Manager supports the Director of Provider Network Operations in the strategic and operational oversight of Provider Relations and PN Operations and Service Development teams. This position is responsible for managing supervisor-level staff, driving operational excellence, supporting provider network initiatives, improving processes, and ensuring effective collaboration across departments. The Manager partners with leadership to develop standardized workflows, improve efficiency, enhance team performance, and support organizational goals related to provider engagement, network adequacy, and operational effectiveness. This position is fulltime remote. Selected candidate must reside in North Carolina. Some travel for onsite meetings to the Home office at Morrisville may be required.

Requirements

Bachelor’s degree from an accredited college or university in a Human Services, Education, Sociology, Business, Public Administration, or related field and seven (7) years of experience in community, business, or governmental programs in health related fields, including two years of supervisory, consultative or administrative experience.
Master’s degree from an accredited college or university in a Human Services, Education, Sociology, Business, Public Administration, or related field and three (3) years of experience in community, business, or governmental programs in health related fields, including two years of supervisory, consultative or administrative experience.
General knowledge of Provider Contract requirements
General healthcare knowledge
Knowledge of database systems for reporting and transmission of data
Thorough knowledge of Microsoft Office Suite, particularly MS Word and MS Excel
Strong interpersonal skills with ability to communicate with appropriate staff
Demonstrated supervision skills
Problem solving skills
Ability to identify and correct credentialing reporting issues via Microsoft Excel and credentialing database
ability to manage several projects
Ability to prepare technical reports

Nice To Haves

Prior experience with Standard Plan or Tailored Plan preferred.

Responsibilities

Support the Director of Provider Network Operations in overseeing daily operations of Provider Relations and PN Operations and Service Development teams
Monitor team performance, service metrics, and operational outcomes
Ensure operational priorities align with organizational goals and strategic initiatives
Assist with planning, implementation, and evaluation of department objectives
Directly supervise Provider Relations Supervisor and Supervisor PN Operations and Service Development
Provide coaching, mentorship, and performance management to supervisory staff
Promote a culture of accountability, collaboration, customer service, and continuous improvement
Support workforce planning, staff development, succession planning, and employee engagement initiatives
Partner with supervisors to identify training needs and professional development opportunities
Identify opportunities to streamline workflows and improve operational efficiency
Develop, implement, and monitor standardized processes, tools, and procedures across Provider Relations and PN Operations and Service Development functions
Collaborate with supervisors and staff to evaluate operational challenges and implement sustainable solutions
Recommend process improvement initiatives that reduce administrative burden, improve consistency, and increase effectiveness
Measure and report on the effectiveness of process improvement initiatives
Work with Human Resources and the Director of Provider Network Operations to attract, maintain, and retain a highly qualified and well-trained workforce
Ensure staff are well trained in and comply with all organization and department policies, procedures, and business processes
Organize workflows and ensure staff understand their roles and responsibilities
Ensure the department has the needed tools and resources to achieve organizational goals and to support employees and ensure compliance with licensure, regulatory, and accreditation requirements
Actively establish and promote a positive, diverse, and inclusive working environment that builds trust
Ensure all staff are treated with respect and dignity
Ensure standards are transparent and applied consistently, impartially, and ethically over time and across all staff members
Work to resolve conflicts and disputes, ensuring that all participants are given a voice
Set goals for performance and deadlines in line with organization goals and vision
Effectively communicate feedback and provide ongoing coaching and mentoring to staff and support a learning environment to advance team skills and professional development
Cultivate and encourage efforts to expand cross-team collaboration and partnership
Develop and analyze operational reports, dashboards, and performance metrics
Monitor departmental goals and key performance indicators
Provide recommendations to the Director of Network Operations regarding operational improvements and strategic opportunities
Ensure compliance with organizational policies, documentation standards, and regulatory requirements
Partner with Contracting, Claims, Quality, Care Management, Finance, and other departments to support provider and operational needs
Facilitate communication and coordination between teams to address system and process issues
Participate in organizational initiatives impacting provider network performance and operations
Take a lead role with special projects related to provider relations, operations and development
Assist Director Provider Network Operations with development of project action plans, participate in special projects as needed to evaluate operational requirements