Job Summary
A managed healthcare and benefits company has a current position open for a Remote Healthcare Network Relations Provider Manager.
Core Responsibilities of this position include:
- Developing and implementing strategies to increase provider engagement in HEDIS and quality initiatives
- Developing and implementing strategies to reduce member access grievances with contracted providers
- Serving as a resource to support Plan's initiatives and helping ensure regulatory requirements and strategic goals are realized
Applicants must meet the following qualifications:
- 5 years’ experience involving servicing individual and groups of physicians, hospitals and integrated delivery systems
- 5 years' experience with ancillary providers with Medicaid and/or Medicare products
- 5+ years previous managed healthcare experience
- 2+ years revenue cycle experience
- 2 years previous supervisory experience
- Experience with community agencies and providers
