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Posted: Thursday, October 5, 2017 4:43 PM

Under general guidance from the Director, Provider Services, the Manager, Provider Services has direct oversight of the Provider Relations Representatives and the Provider Relations Coordinator. . This position for managing and building long:term relationships with delegated groups, directly contracted physicians, ancillary providers and their staff in a positive and proactive manner in order to support their understanding and compliance with Alliance contracts, policies, and procedures. The Manager partners with other departmental Managers and Directors on all matters as they relate to provider relations services and programs.Principal responsibilities include: Provide day:to:day supervision to the Provider Relations Representatives. Manage daily functions of Provider Relations Coordinator Monitor and report Provider Relations RepresentativesA? monthly and quarterly metrics to management staff. Periodically attend site visits with PR Reps for staff development and quality assurance. Develop provider training materials in collaboration with Provider Services staff. Develop materials for provider quarterly packets. Provide oversight of provider trainings, monitor goals and ensure department and company standards are met. Ensure PR representatives meet minimum provider visit standards. Manage monthly new provider credentialing reports to ensure New Provider Orientations are conducted within timeframe. Monitor, evaluate and complete written performance evaluations of direct reports. Monitor accuracy of provider materials and information on the Alliance website. Participate in additional department projects as needed Maintain the Provider Relations policies and procedures to meet strategic goals and ensure regulatory/contractual compliance; help design, develop, manage and improve the Departments performance, policies and procedures. Foster and maintain proactive positive relations throughout the provider network by communicating with provider offices through face:to:face visits, letters, telephone calls, faxes or emails for the purposes of promoting the Alliance, sharing data and information about the physicianA?s practice, Alliance processes and other miscellaneous updates as well as for gathering information and feedback from the provider about any issues or concerns related to the Alliance or healthcare in general. Effectively identify, direct, and/or research provider operational issues for timely resolution per Alliance and state requirements through a thorough knowledge of all areas of Alliance operations and a strong working relationship with other departments. Assess the composition of the existing network, the opportunities for expansion in assigned territories and the availability of services in the surrounding communities to provide a comprehensive overview and understanding of the medical community to both internal and external customers. Recruit both new providers for participation in the Alliance network and existing providers for new lines of business and/or projects. Arrange for and conduct office manager group seminars and physician seminars and meetings including such tasks as scheduling a meeting space, locating speakers and preparing invitations, agendas, presentations, and handouts. Report from databases and other resources to provide information about the network to internal and external customers. Contribute to the development of written communications for the provider bulletin, manual, website and other publications and ad hoc reports and letters. Monitor accuracy of provider materials and information on the Alliance website. Supervise in:house projects, mailings and special projects as assigned. Participate in internal and external workgroups and meetings. Perform other duties and special projects as assigned. ESSENTIAL FUNCTIONS OF THE JOB Identify and research a variety of issues related to provider contracting, compliance and operational issues utilizing various sources including, but not limited to,

Source: https://www.tiptopjob.com/jobs/72766093_job.asp?source=backpage


• Location: East Bay

• Post ID: 84049477 eastbay
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