Manager, provider relations job description

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.

The Provider Relations Manager is responsible for the delivery of all operational services through direct oversight and leadership of the Provider Relations team. In addition to maintaining the client relationship and identifying cost savings and efficiencies, the Provider Relations Manager is charged with developing and deploying ongoing strategies to communicate with and educate the Connecticut Medical Assistance Program's provider community so that providers may effectively participate in the Medicaid program.
Your role in our mission

* Oversees, supports, and monitors day-to-day team activities to ensure timely and effective execution to meet team Service Level Agreements and corporate assigned deliverables
* Works with the technical team to clarify business requirements of upcoming changes and in turn provides leadership to the team to ensure all provider-facing content is developed for the education of providers on upcoming new programs or changes to existing policies
* Point of contact for client inquiries and time-sensitive provider communication requests.
* Manages and collaborates with the call centers, provider enrollment team, claims team, pharmacy team, and Gainwell technical resources to identify impacts of changes, develop processes and resolve issues
* Coordinates with other State vendors to understand processes, interactions, and potential impacts

What we're looking for

* At least 3 years' experience in performing provider relations activities for a health care insurer, preferably an MMIS
* Strong working knowledge of Medicaid claims to process
* Strong working understanding of all aspects of provider communication methods including Web site maintenance using applications such as Adobe and SharePoint Designer
* At least 3-5 years of experience in a management role

What you should expect in this role

* Remote/Hybrid
* Primarily the position is remote but periodically attends meetings on-site located in East Hartford, CT.

The pay range for this position is $86,200.00 - $107,800.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.

Why Work Here

Working at Integrity flat-out rocks. Why? Because we put people first - and we want you to thrive in a career that you love. We're proud of our working environment and culture, where we reward your hard work and support your strong values.

Joining us means being part of a hyper-growth company with all kinds of professional opportunities for those who are ready. Are you ready? At Integrity, we start with competitive compensation and just get better from there.

We love celebrating all your hard work with fun and swag - and we love giving back! You can look forward to friendly competitions and contests, as well as activities that help raise money for charities in the communities we serve.

At Integrity, we include benefits that make work-life more fun with more peace of mind for you. These benefits include but are not limited to:

* Generous PTO and holiday schedule, with extra time off for community service and your birthday
* Multiple health insurance plans to choose from
* 401(k) with immediately vested employer matching
* Integrity-paid HSA contributions for eligible health plans
* Employee ownership program after one year, which grants meaningful ownership in Integrity's ongoing success

Job Description

The Manager of Provider Relations is responsible for the development and ongoing management of Provider Relations. The primary job functions will be: training and providing support for agents working with medical groups across the country, overseeing the development of workflows and workplans with Medical Group Partners serving as a liaison between our Community Based Providers and our operations teams, as well as, educating our agents and agencies about the benefits of the collaborative, mutual accountable approach to working with our Medical Group Partners; developing materials to support outreach efforts, networking with professionals in the healthcare industry to help establish AGA as the premier FMO in the market, represent AGA at community events, establish relationships with key people in the key markets and recognize market trends and opportunities; assist with social media and digital marketing; assist with accurate reporting of results to prove ROI of all efforts.

Position Responsibilities

Responsibilities include, but are not limited to:

* Developing scalable workflows and workplans for our Medical Group Partners.
* Serving as a liaison between our Medical Groups, vendors, and internal operations teams.
* Completes ongoing training and skill-building activities.
* Assists with recruitment of new agents/agencies by attending events to that purpose.
* Assists with qualitative surveying/reports of activity and results of collaborative marketing efforts for medical groups.
* Willingness and ability to accept increasing responsibility.
* Attend and participate in staff meetings, in-services, projects, and committees as assigned.
* Be flexible in schedule of hours worked.
* Requires use of personal vehicle.
* Project management of Medical Group campaigns, coordinating efforts between Medical Groups, vendors, operations and marketing.
* Assist Medical Group partners to develop campaign goals and distilling initiatives to marketing.
* Identify marketing collateral or resources to better serve Medical Group or sales.
* Represent AGA on partnership events that could include radio, television or seminars.

Integrity Marketing Group, LLC is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, national origin, disability, veteran status, or any other characteristic protected by federal, state, or local law. In addition, Integrity Marketing Group, LLC will provide reasonable accommodations for qualified individuals with disabilities.

You could be the one who changes everything for our 26 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Responsible for maintaining existing and developing new provider relations, and assisting with contracting activities
• Manage the staff in contracting area including work flow, training and communication standards

• Manage day-to-day provider relations activities and provider relations department

• Develop, implement and maintain production and quality standards for the contracting staff

• Monitor and analyze costs and prepare departmental budget

• Initiate and execute standard physician and ancillary provider contracts

• Coordinate all pre-contract activities with providers such as, site visits, credentialing, orientation to contractual requirements, etc.

• Maintain contracts and correspondence files in organized and accessible manner for all providers

• Prepare and analyze information to evaluate the need for additional health plan providers

• Manage and coordinate customized provider contracts and hospital contracts

• Participate in physician and ancillary provider contracting and provider relations in foreign state markets through implementation and startup phases

Education/Experience:

+ Bachelor's degree in related field or equivalent experience.

+ 4+ years of managed care, health delivery system and/or project and staff management experience.

+ Experience with state and federal health programs such as Medicaid and Medicare.

+ Provider relations/contracting experience including solid communication and negotiation skills.

+ Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

**TITLE:** Manager, Provider Relations

**LOCATION:** Sacramento, California

**REQNUMBER:** 1331086