Medicare Network Manager

Jobgether•Colorado, CO

8d•Remote

About The Position

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Senior Medicare Network Manager - REMOTE. In this role, you will play a vital part in developing and maintaining specialized networks tailored to the needs of Medicare Advantage populations. You will ensure high operational standards and vendor satisfaction, managing daily interactions with vendors like an Account Manager. Your ability to build strong relationships across functional departments will be critical to maintaining efficient and effective networks, ultimately contributing to the overall success of our partners in providing quality services. Accountabilities Work with Transportation Providers to resolve service issues and troubleshoot problems. Utilize data to develop and implement performance improvement plans (PIP). Coordinate and conduct monthly provider performance evaluations. Handle offboarding for providers not meeting expected standards. Serve as the primary contact for vendor service requests and escalations. Manage day-to-day vendor interactions and ensure satisfaction. Conduct on-site vehicle inspections and audits for compliance with standards. Deliver operational support to all vendors in a designated geographic area. Collaborate with internal teams to resolve Transportation Provider issues. Provide consultations and guidance to Transportation Providers and internal staff. Utilize Salesforce for managing vendor interactions and compliance. Educate Transportation Provider contacts on operational processes. Foster partnerships with assigned transportation providers. Assist in facilitating regular provider town hall meetings. Address inbound service requests and ensure proper assignment. Liaise with internal departments to resolve vendor inquiries. Support transportation providers with claims, payments, and eligibility questions. Meet assigned KPIs and business objectives. Ensure compliance through inspections and audits. Submit provider configuration changes to the data management team.

Requirements

High School diploma or GED required.
College Degree or Equivalent Work Experience preferred.
2-5 years’ experience as an Account Manager is essential.
Minimum of 2 years’ operational experience required.
Valid driver’s license is necessary.
Ability to conduct inspections and audits courteously.
Demonstrate excellent time management skills.
Ability to maintain a positive attitude in high-stress situations.
Strong negotiation and communication skills.
Attention to detail is critical.
Ability to maintain confidentiality at all times.
Skilled in prioritizing projects and incidents.
Empathize with customer needs and circumstances.
Ability to handle emergent situations appropriately.

Nice To Haves

Knowledge of transportation logistics and managed care is a plus.

Responsibilities

Work with Transportation Providers to resolve service issues and troubleshoot problems.
Utilize data to develop and implement performance improvement plans (PIP).
Coordinate and conduct monthly provider performance evaluations.
Handle offboarding for providers not meeting expected standards.
Serve as the primary contact for vendor service requests and escalations.
Manage day-to-day vendor interactions and ensure satisfaction.
Conduct on-site vehicle inspections and audits for compliance with standards.
Deliver operational support to all vendors in a designated geographic area.
Collaborate with internal teams to resolve Transportation Provider issues.
Provide consultations and guidance to Transportation Providers and internal staff.
Utilize Salesforce for managing vendor interactions and compliance.
Educate Transportation Provider contacts on operational processes.
Foster partnerships with assigned transportation providers.
Assist in facilitating regular provider town hall meetings.
Address inbound service requests and ensure proper assignment.
Liaise with internal departments to resolve vendor inquiries.
Support transportation providers with claims, payments, and eligibility questions.
Meet assigned KPIs and business objectives.
Ensure compliance through inspections and audits.
Submit provider configuration changes to the data management team.