Acts as the primary resource for assigned profile of larger and more complex providers to establish, oversee, and maintain provider risk management and positive relationships.
Drives the implementation of internal and external solutions to achieve provider satisfaction, cost targets, network growth, and efficiency targets.
Collaborates cross-functionally to ensure resolution of escalated issues or projects for assigned provider systems.
Educates internal and external parties as needed to ensure compliance with contract policies and parameters.
Meets with key providers periodically to ensure service levels are meeting expectations.
Manages the development of agenda, validates materials, and facilitates external provider meetings.
May collaborate cross functionally on the implementation of large provider systems.
Requirements
4+ years' experience in business segment specific environment servicing or managing non-standard relationships with providers with exposure to benefit plan design and/or contract interpretation.
3-5 years' experience with business segment specific policy, benefits, plan design and language.
Working knowledge of business segment specific codes, products, and terminology.
Strong verbal and written communication, interpersonal, problem resolution and critical thinking skills with proven ability to influence and collaborate with providers and partners at all levels.
Benefits
Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs
Confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
provider risk managementbenefit plan designcontract interpretationpolicy managementproblem resolutioncritical thinking