Provider Network Manager at Impresiv Health | Torre
Provider Network Manager
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Impresiv Health

Provider Network Manager

Impresiv Health
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(2.3K) info
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Full-time

Legal agreement: Contractor

Currency exchange and payroll taxes to be paid by:

Depends on the location of the candidate

Compensation
USD50k - 70k/year
Non-negotiable
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Hybrid (United States)
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Posted over 5 years ago

Requirements and responsibilities

• Responsible for the daily operations of the Provider Relations department • Establishes and maintains strong business relationships with Hospitals, Medical Groups, IPAs and Ancillary providers • Manages the out of network process to ensure continuity of care and support business growth • Ensures providers and interdepartmental inquiries are handled effectively and in a timely manner • Proactively identify challenging situations and ensure appropriate action is taken to mitigate escalation with Providers • Support providers and respond to questions, concerns, and suggestions • Resolves provider complaints in a timely manner to ensure provider/member satisfaction • Initiates and maintains follow-up contact with providers following resolution of issues to ensure they remain resolved • Partners with the Medical Management team to identify and measure methods to improve process and workflows • Partners and collaborates with Business Development to support provider activities consistent with the client's growth initiatives • Collaborates with other operational departments and functional business unit stakeholders to meet the client's overall goals • Monitor accuracy of provider materials and information on the client's Managed Care website • Oversees the process that all providers are Credentialed and Re-credentialed in a timely manner, and in accordance with State, Federal and Company policies and procedures • Responsible for ensuring delegated entities, including IPAs, large groups and hospitals submit monthly additions and terminations to the network in accordance with established guidelines, including monthly verification of exclusion checks and sanctions • Ensures site visits, orientations, access & availability audits and educational sessions are conducted in accordance with established standards and in a timely manner
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