E-Verify Program

Manager, Strategic Provider Support

E-Verify Program

full-time

Posted on:

Location Type: Remote

Location: North Carolina • United States

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Salary

💰 $73,698 - $117,917 per year

Job Level

SeniorLead

About the role

  • Develop performance goals and track performance against established goals.
  • Handle complex employee issues.
  • Conduct random audits of teams work.
  • Review audit results with staff and create performance improvement plans as necessary.
  • Develop and implement training plans to ensure growth and development for staff.
  • Develop staff provider relation skills and provider communication through formal and informal training, coaching, and feedback.
  • Interpret and analyze complex data from staffing models and other sources to identify issues and make recommendations for effective solutions.
  • Develop resource allocation strategies to meet changing business demands.
  • Represent BCBSNC in stakeholder meetings to address stakeholder inefficiencies and to ensure contractual compliance.
  • Plan all on-site visits to stakeholders to educate on BCBSNC medical or administrative policies and procedures.
  • Address stakeholder concerns and non-compliance contract/administrative issues.
  • Coordinate the required corrective actions.
  • Partner with assigned stakeholders to understand their processes, procedures and systems as they relate to the way they conduct business with BCBSNC.
  • Develop and maintain extensive knowledge of key stakeholders and/or regional territories.
  • Track stakeholder issues for root-cause analysis, escalation, and closure.
  • Document issue resolution using issue resolution protocol.
  • Comply with state, federal and BCBSA regulations governing stakeholders and suggests implementation of any product, process, or system modifications to ensure compliance.
  • Identify opportunities to control medical expense and deploy action plans to accomplish stakeholder-specific or regional medical expense goals.
  • Participate in negotiations with stakeholders as needed.
  • Manage day-to-day consultative activities for a high-profile healthcare system.
  • Provide analysis and feedback for technologies, trends, best practices and service offerings to incorporate them into overall stakeholder business solutions.
  • Lead team of onsite coordinators in identifying, analyzing, and resolving complex operational issues impacting the healthcare system.

Requirements

  • Bachelor's degree or advanced degree (where required).
  • 8+ years of experience in related field.
  • In lieu of degree, 10+ years of experience in related field.
  • LEAN certification advanced within 12 months of hire.
  • Experience in provider interactions with institutional, professional and ancillary providers.
  • Experience in claims, customer service, membership, enrollment or a call center environment.
  • Experience managing a project.
  • Ability to interpret policy provisions.
  • Excellent interpersonal and relationship building skills.
  • Strong data analysis and problem-solving skills.
  • Knowledge of institutional and ancillary pricing, health care finance, hospital and ancillary payments.
  • Strong negotiation skills.
  • Ability to effectively manage multiple high priority and high-profile tasks/provider relationships.
Benefits
  • Medical, dental, and vision coverage along with numerous health and wellness programs.
  • Parental leave and support plus adoption and surrogacy assistance.
  • Career development programs and tuition reimbursement for continued education.
  • 401k match including an annual company contribution.
  • Work-life balance, flexibility, and the autonomy to do great work.
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
data analysisperformance improvement plansresource allocation strategiesissue resolution protocolstakeholder managementproject managementpolicy interpretationmedical expense controlnegotiation
Soft Skills
interpersonal skillsrelationship buildingproblem-solvingcommunicationcoachingfeedbackteam leadershipconsultative activitiestraining development
Certifications
LEAN certification