VSP-posted 3 months ago
$94,500 - $152,250/Yr
Full-time • Manager
Hybrid • Sacramento, CA
Food Services and Drinking Places

Responsible for leading network growth by attracting and retaining doctors and strategic partners to the network. Support ongoing and future network provider integrations and initiatives. Provide operational support, defining and delivering comprehensive new system enhancements, processes, and training to meet state, federal, and client requirements. Direct the Provider Network teams responsible for recruitment and retention of providers across all VSP networks and the implementation and operational management of provider data to ensure accurate claim submission, doctor payments, tiered provider benefits, and provider directory. Communicate strategic goals and the impact the teams' efforts have in achieving the division and organizational goals. Lead and manage network operational activities across all modalities including independent private practice, retail and strategic providers, telehealth, mobile, and all network exceptions. Participate in the development of key division initiatives; lead and manage the implementation of assigned corporate strategies and follow up on operational performance, training, and metrics for Provider Network to ensure operational stability. Accountable for data integrity oversight within the Network Development team. Manage the network in accordance with provider contractual obligations. Direct the team to achieve and maintain service goals including implementing process and system changes to create operational efficiencies. Responsible for the Provider Network phone line and email boxes. Work closely with SBUs, payment and product integration, and regulatory compliance and participate on client calls as a Network Subject Matter Expert. Partner with Legal on developing and reviewing vendor contracts, unique practice ownership scenarios and provider escalations. Responsible for the deployment and delivery of insurance and regulatory training content for providers and their staff to ensure state and federal requirements are met. Responsible for provider networks, including maintaining appropriate access and developing and maintaining compliance with network standards across all networks as well as client specific network performance guarantees. Oversee business area impact assessments, business analysis and implementation of corporate and divisional projects, ensuring operational readiness. Partner with division leadership and business partners, to recommend solutions or enhancements to the provider network.

  • Lead network growth by attracting and retaining doctors and strategic partners.
  • Support ongoing and future network provider integrations and initiatives.
  • Provide operational support and deliver comprehensive new system enhancements.
  • Direct the Provider Network teams for recruitment and retention of providers.
  • Ensure accurate claim submission, doctor payments, and tiered provider benefits.
  • Communicate strategic goals and their impact on division and organizational goals.
  • Manage network operational activities across various modalities.
  • Participate in the development of key division initiatives.
  • Accountable for data integrity oversight within the Network Development team.
  • Manage the network in accordance with provider contractual obligations.
  • Achieve and maintain service goals through process and system changes.
  • Oversee the Provider Network phone line and email boxes.
  • Work closely with SBUs and participate on client calls as a Network Subject Matter Expert.
  • Partner with Legal on vendor contracts and provider escalations.
  • Deploy and deliver insurance and regulatory training content for providers.
  • Maintain compliance with network standards and performance guarantees.
  • Oversee business area impact assessments and implementation of projects.
  • Recommend solutions or enhancements to the provider network.
  • Bachelor's degree in related field or equivalent experience.
  • Minimum of 3 years of management experience.
  • Minimum of 8 years' experience in the health care industry or equivalent preferred.
  • Demonstrated ability to resolve complex issues.
  • Ability to learn, interpret and apply information in contractual documents.
  • Excellent leadership, communication, and interpersonal skills.
  • Ability to travel as needed.
  • Skilled in managing multiple complex division projects.
  • Strong interpersonal and organizational skills.
  • Strong written and oral communication skills.
  • Eligible bonuses and commissions.
  • Comprehensive health benefits.
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