Provider Relations Manager

SCAN Health Insurance

1d • Remote

About The Position

The Provider Relations Manager will be responsible for building and maintaining effective provider relationships with medical groups and their associated primary care physicians, specialists, hospitals and ancillaries. This role will manage a team of locally based Provider Relations individuals across SCAN’s Southern California market. The job entails partnering closely with Network Management Contracting counterparts to facilitate an integrated provider onboarding process, conducting provider awareness and orientation about SCAN Health Plan, ongoing education and outreach, relationship building with office staff and providers, and quarterbacking the overall relationship including acting as the liaison with cross-functional stakeholders across reporting needs, performance monitoring, issue resolution, and clinical programs or growth efforts with the medical group and their providers. There will be daily interface with office staff and providers, as well as interactions with corporate leadership at medical groups and constant collaboration with internal stakeholders to effectively establish and maintain a positive provider experience and resolve escalated issues in a timely manner.

Requirements

• Bachelor’s Degree in discipline related to SCAN’s products, programs, services, and/or business operations.
• 8 years of experience in relevant healthcare or Medicare Advantage products, programs, services and/or business operations
• 5 years of experience managing a team.
• Excellent project management skills with experience in leading large, complex and/or long term projects.
• Excellent problem solving skills with the ability to find creative solutions for issues where the answers are not clear.
• Ability to collect large magnitude of business subject matter knowledge and connect dots across the organization.
• Strong analytical skills with the ability to use statistical tools and interpret and apply the results.
• Highly developed quantitative, oral, written and interpersonal communications skills with the ability to effectively convey information in a clear and concise manner.
• Strong platform and presentation skills.
• Proactive and independent thinker.
• Strong multi-tasking and organizational skills with minimal supervision.
• Team-player, innovative, problem solver, detail oriented.
• Ability to execute work under pressure and tight deadlines.

Nice To Haves

• Experience in the Health Care industry is strongly preferred.

Responsibilities

• Serve as primary contact for Southern California medical groups and their associated primary care physicians, specialists, hospitals and ancillaries and act as a key liaison between the group/providers and health plan.
• Closely partners with Network Management Contracting to facilitate an integrated onboarding experience, leading project management planning for cross-functional onboarding efforts and establishing a robust playbook.
• Establish and maintain excellent relationships with the provider network, with in-market travel to meet with medical group corporate leadership/providers and support the locally based Provider Relations individual(s) as needed.
• Manage oversight of the locally based Provider Relations team including tracking of office staff and provider orientations, ongoing education and engagement tactics, quality and performance trainings and participation in relevant programs, driving growth strategies, as well as relationship building both virtually and via onsite visits.
• Investigates and responds to escalated provider concerns and issues.
• Monitors trends or insights and partners with Network Operations on developing new processes for improvement.
• Represents as a key business leader for driving forward initiatives to improve the provider experience with SCAN.
• Supports creation and improvement of templates for educational materials and formal presentations to support provider touchpoints and initiatives.
• Partners with cross-functional teams to have quality performance monitoring of the provider network, and liaison for actions that need to be taken for improvement or learnings.
• Coordinates data extracts and data analysis interpretation.
• Partners with other in the Network Management departments on having a pulse of network adequacy and robustness of local provider access and reputation to evaluate the need for changes to the provider network; supports on internal awareness of such changes.
• Acts as a key liaison for Network needs to support clinical programs or growth efforts.
• Ensures SCAN and its contracted medical groups and providers follow regulatory requirements.
• Supports or leads on internal company initiatives/projects/process improvements that further improve provider experience.
• Actively support the achievement of SCAN’s Vision and Goals.
• Other duties as assigned.

Benefits

• Base Pay Range: $106,200 - $182,983 Annually
• Work Mode: Mostly Remote
• An annual employee bonus program
• Robust Wellness Program
• Generous paid-time-off (PTO)
• 11 paid holidays per year, plus 1 additional floating holiday
• Excellent 401(k) Retirement Saving Plan with employer match
• Robust employee recognition program
• Tuition reimbursement
• An opportunity to become part of a team that makes a difference to our members and our community every day!

What This Job Offers

• Job Type: Full-time
• Career Level: Manager