Assists with prioritizing corporate functions and focuses on producing revenue for the corporation through the effective coaching and developing of Representatives to build relationships and manage the accounts of their Providers.
Reports to: Sr. Director Provider Relations
Department: Network Development
Location: Pensacola, FL
Additional Responsibilities: Candidate Education:
- Leads and develops a team of Provider Relations Reps and Provider Ops Coordinators.
- Conducts ride-alongs with Reps in the field to develop skills and behaviors and document progress/provide formative feedback through timely and consistent Field Trip Reports.
- Conducts and directs provider contracting/negotiations and provider servicing.
- Performs data analysis and develops specific actions to manage medical cost trend.
- Assists in developing practices to assist risk partners in managing financial risk.
- Identifies areas to improve provider service levels.
- Educates/enhances relationships within the provider community.
- Assists in developing provider contracting and service.
- Strategizes for membership growth and retention.
- Special projects as assigned or directed.
- Preferred A Bachelor's Degree in a related field
- Required or equivalent work experience
- Required 5 years of experience in Provider Relations or similar background
- Required 3 years of experience in Management, Supervisory, or Lead/Sr. role with demonstrated leadership ability or program management experience
- Preferred Other HMO/PPO background
Licenses and Certifications:
- Intermediate Ability to lead/manage others
- Advanced Demonstrated interpersonal/verbal communication skills
- Advanced Knowledge of healthcare delivery Strong functional and technical knowledge of healthcare delivery
- Advanced Ability to influence internal and external constituents
- Advanced Demonstrated analytical skills
- Intermediate Other Facilitative skills
- Advanced Other Financial skills
- Advanced Other Knowledge of CMS and state regulations
A license in one of the following is required:
- Required Advanced Microsoft Word
- Required Advanced Microsoft Excel