Manager, Provider Network

Chapters Health System • Fort Myers, FL

302d

About The Position

It's inspiring to work with a company where people truly BELIEVE in what they're doing! When you become part of the Chapters Health Team, you'll realize it's more than a job. It's a mission. We're committed to providing outstanding patient care and a high level of customer service in our communities every day. Our employees make all the difference in our success! The role is responsible for the organization, management, and expansion of Chapters Health System's provider network, including the establishment and maintenance of processes and systems to provide routine services to patients, including contract management and credentialing. The ideal candidate will have a strong background in health administration strategy, provider operations, provider contracting, provider data management, and credentialing.

Requirements

• Bachelor's degree in Healthcare Administration, Business, or a related field, preferred.
• A minimum of 7 years of experience in provider network management, healthcare contracting, healthcare operations, provider credentialing, or related roles.
• A strong understanding of healthcare delivery systems, payer-provider relationships, and regulatory compliance.
• Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint) and provider data management, credentialing and contracting software.
• Exceptional problem-solving and analytical skills.
• The ability to work independently and collaboratively in a team setting.
• Strong negotiation and conflict resolution skills.
• Excellent communication and interpersonal skills for managing provider relationships and interacting with cross-functional teams.
• Leadership experience, and proven ability to manage multiple priorities in a fast-paced environment.

Responsibilities

• Demonstrate knowledge of the vendors and solutions in the market to help make efficient and accurate provider data to meet internal and external stakeholders' needs.
• Analyze provider data systems to ensure they support organizational goals for compliance, access, and reporting.
• Administer provider data systems, including but not limited to contract and software applications.
• Work with clients to streamline data management processes, reducing errors and improving timeliness.
• Be familiar with the contract lifecycle management process, including negotiations and contract management with healthcare providers, ensuring that terms align with organizational goals, compliance standards, and financial objectives.
• Provide insights on reimbursement models and advise on contract optimization strategies.
• Development and maintenance of provider contracting policies and procedures and workflows.
• Understand the Provider Credentialing and Re-Credentialing process including onboarding, Primary Source Verification (PSV), and Credentialing Committee.
• Advise on best practices for maintaining accurate credentialing records and meeting regulatory standards.
• Evaluate and improve onboarding workflows, ensuring timely and compliant provider activation.
• Development of credentialing policies and procedures, workflows, and forms.
• Develop onboarding processes and training materials related to onboarding new providers to our health system networks, ensuring they understand organizational goals, policies, and clinical guidelines.
• Lead or participate in provider network management projects aimed at improving system processes, provider experience and coordination, and overall network stability.
• Manage timelines, deliverables, and stakeholder communications to ensure successful project outcomes.
• Provide regular updates and performance reports to operational leaders, highlighting progress and areas for improvement.
• Be responsible for and provide oversight of the enterprise Credentialing Services and Contracting Services functions.
• Mentor and manage Contracts Manager and Credentialing Manager, fostering a collaborative and growth-oriented environment.
• Provide feedback and coaching to team members, supporting their professional development and project contributions.
• Stay informed about provider network trends, regulatory changes, and technology advancements.
• Contribute to internal knowledge sharing through case studies or presentations, enhancing the system's expertise and reputation.

Benefits

• Consent to drug and/or alcohol testing after a conditional offer of employment is made, as well as ongoing compliance with the Drug-Free Workplace Policy.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Industry: Ambulatory Health Care Services
• Education Level: Bachelor's degree