Provider Network Manager

Leidos

20h•Remote

About The Position

Leidos Health and Services Sector is seeking a Provider Network Manager to work remotely, supporting the Military OneSource mission. The Military OneSource Program offers 24/7 support services to military members and their families, similar to a commercial Employee Assistance Program (EAP), providing information, resources, education, referrals, and counseling to approximately 4.7 million participants globally. The Provider Network Manager is responsible for the overall oversight of the behavioral health counselor provider network. This includes leading, directing, and managing Provider Network Supervisors' workflows and performance to ensure effective service delivery. The role involves using technical tools to identify trends and issues, overseeing quality metrics, and developing and maintaining Standard Operating Procedures (SOPs) to meet Service Level Agreements (SLAs) and Performance Metrics. The manager will continuously assess and refine service delivery processes, monitor participant feedback and provider performance, track provider scorecards, and ensure timely and accurate completion of provider documentation and billing. Additionally, the position involves mentoring Provider Network Supervisors and fostering strong working relationships with provider network subcontractors and the Leidos program management team.

Requirements

Bachelors’ degree from an accredited university
5+ years progressive experience working directly with provider relations network specific to behavioral health
Experience with network provider recruitment, network gap analysis, provider credentialing and onboarding experience.
Experience working closely with subcontractors in a management role.
Minimum of five years of supervisory or people management experience in a similar program environment.
Strong project management skills with demonstrated ability to deliver services within established timelines, budget parameters, and quality standards.
Strong customer service skills and demonstrated knowledge of call center operations.
Ability to build strong customer relationships and deliver solutions
Ability to exhibit strong business and financial acumen
Ability to develop strategy, plan and prioritize work aligned to program/organization goals, and deliver solutions for the business
Ability to establish clear responsibilities, processes and accountability measures for your team
Ability to build effective teams and talented team members
Ability to assist employees in meeting both their career and organizational goals
Ability to motivate, drive engagement, vision, and gain trust through honesty, integrity, and authenticity from your team
Ability to consistently achieve results under tough circumstances and manage complex situations
Proficiency in Microsoft Office applications including Word, Outlook, Excel, as well as web-based research and electronic documentation systems.
Strong analytical, organizational, and leadership skills.
U.S. citizenship and fluency in English required.
Ability to successfully pass criminal history, fingerprint background checks, and credential verification required.
Ability to maintain and retain suitability investigation and clearance as required.
Proficient in navigating electronic systems, computer programs, and virtual service platforms.
This position requires a separate, quiet, private, confidential space to work from, as well as having access to your own reliable high-speed internet hard wired to your home (coax or fiber from the Internet Service Provider (ISP) to your home.) Using a hot spot from a mobile device (tethering) or wireless ISP is not acceptable.

Nice To Haves

People leader management or supervisory experience
Strong background in provider relations, including developing and maintaining a behavioral health provider network
Subcontract management experience

Responsibilities

Leads, directs, and manages Provider Network Supervisors’ workflows and performance to ensure effective service delivery.
Uses technical tools and applications to identify trends, issues, and recommendations for process improvements.
Oversees quality metrics and continuity of services and are responsible for developing, implementing, and maintaining Standard Operating Procedures (SOPs) and workflows to meet or exceed established Service Level Agreements (SLAs) and Performance Metrics.
Continuously assesses and collaborates to refine service delivery processes and procedures to optimize efficiency and customer satisfaction.
Monitors participant feedback scores and provider performance measures and develop and track provider scorecards to ensure consistent, high-quality, and timely service delivery.
Monitors the timely and accurate completion of provider documentation and billing submissions.
Provides mentoring, guidance, and supplemental training to Provider Network Supervisors.
Fosters strong working relationships with provider network subcontractors and the Leidos program management team through effective communication, collaboration, and partnership to promote a unified, high-performing culture.
Provide operational oversight of the Provider Network to ensure effective, compliant, and high-quality service delivery.
Lead, direct, and manage Provider Network Supervisors, overseeing workflows, performance metrics, and service quality.
Provide guidance and direction on escalated cases.
Handle escalated provider and client complaints, claims, authorization issues, and complex problem resolution matters.
Lead recurring operational meetings to review escalated cases, analyze data trends, and address matters requiring higher visibility.
Develop, implement, and maintain Standard Operating Procedures (SOPs) and workflows to meet or exceed established Service Level Agreements (SLAs) and performance metrics.
Monitor counseling quality metrics, client feedback scores, and provider performance measures; develop and maintain provider scorecards to ensure consistent service quality.
Utilize tools such as MS Office applications and EHR systems to analyze performance data and provide recurring metric reports.
Track provider referral volumes to identify high-performing providers eligible for incentives, low- or no-volume providers, and providers requiring corrective action or removal from the roster.
Ensure timely and accurate completion of provider documentation.
Engage with provider network subcontractors to address performance concerns, contractual issues, and service improvements.
Mentor and provide supplemental training to Provider Network Supervisors to strengthen leadership and operational effectiveness.
Escalate high-visibility events and maintain required Quality Assurance (QA) and Quality Control (QC) documentation.
Foster collaborative relationships with subcontractors and program leadership to promote alignment, communication, and a high-performing team culture.
Perform additional duties and special projects as assigned based on business needs.