Senior Manager, Provider Relations

Position Purpose: Leads team of Provider Relations Representatives, Network Performance Advisors and/or Provider Relations Supervisors to effectively manage assigned region and/or market territory. Develops Provider Relations Team to achieve market performance targets through the implementation and execution of network transformation strategies in order to improve overall Network Performance.

Candidate Education: Required A Bachelor's Degree in a related field

- Leads and develops a team of Provider Relations Representatives, Provider Relations Supervisors and/or Network Performance Advisors. - 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. - Identifies team skill set deficiencies and implements proper professional development plans. - Monitors Provider Performance action plans and tracks provider performance improvement. - Ensures compliance with enterprise provider performance and relationship model and team engagement of provider performance reporting. - Responsible for understanding the differences between Risk and Value-Based contractual arrangements. - Responsible for understanding HEDIS and STARS measures and partners with Quality Team to drive improvement of quality provider performance. - Plans, prepares and executes effective group meetings/discussions with proper objectives and outcomes. - Ensures adherence to contractual obligations and to regulatory requirements. - Identifies areas of opportunity to improve Provider Satisfaction and Provider Experience. - Assists in monitoring and developing High Performing Practices and driving Network Transformation Strategies to optimize member outcomes. - Educates and enhances provider partnerships and implements market and enterprise initiatives. - Strategizes membership growth for High Performing Practices and/or sophisticated complex provider relationships. - Provides training, mentoring and guidance to new managers. - Special projects as assigned or directed.Additional

Responsibilities: * Leads and develops Provider Operations staff.

Required or equivalent work experienceCandidate Experience: Required 6+ years of experience in provider relations or similar background Required 3+ years of management experience