Manager of Provider Relations Position Available In New York, New York

Manager of Provider Relations CareAbout Health New York, NY Job Details Full-time $70,000 – $109,000 a year 1 hour ago Benefits Paid holidays Disability insurance Dental insurance Paid time off Vision insurance 401(k) matching Life insurance Qualifications Management Managed care 3 years Presentation skills Bachelor’s degree Team management Conflict management Senior level Leadership Communication skills Full Job Description New York, New York 10036 Company Description CareAbout Health is a managed services organization (MSO) that provides expert advice, resources, tools, and other support to its portfolio of medical groups and healthcare focused companies. CareAbout Health is helping align incentives to create a world where patients, providers, and payers work together in a seamless, coordinated manner toward common goals: higher quality, lower cost, better outcomes.

Role Title:

Manager of Provider Relations FLSA Category:

Exempt Role Location:

Remote Reporting Relationships:

This position reports to the Chief Operating Officer.

Role Summary and Responsibilities:

As the Manager of Provider Relations, you will provide consulting support to leadership and physicians in making strategic quality-related decisions by internally managing, manipulating, tracking, and analyzing physician performance. This entails working with internal and external resources to gather information, and presenting the data to various leaders, physicians, and/or staff within MSPB. Key Responsibilities /

Essential Functions:

Provide a high level of expertise in systems relating to assigned areas in the Operations and Value Based Team. Analyze claims data, office performance metrics and E.H.R. information to identify trends impacting the business, by focusing on growth, MLR, Hospitalization, MRA and Quality. Develop and manage Utilization meetings within the organization. Manage Hospital claims and initiate action plans for each office with the CMO, Medical Director and Leadership team. Manage and analyze Medicare Risk Adjustment (MRA) trends, Quality Measures, Annual Health Assessment performance. Manage Population Health with the Analytics Team. Establishes and maintains strong communications and collegial partnerships with providers. Conducts provide education and training on an as needed, ongoing basis. Take the lead in responding to and resolving provider issues. Facilitate problem solving with other internal operations stakeholders and health plan providers relations personnel to achieve resolution and positive outcomes wherever possible for providers. Assumes role in researching provider issues, collaborates with staff from various internal operations areas to determine root causes. Remedies problems, being on point to communicate with providers throughout the course of problem resolution. Develops and maintain strategic and tactical approaches to relating to high-impact providers in the network that will distinguish the company in the industry and result in peak provider satisfaction. Established and maintains optimal communication channels with client provider relations and account management to foster confidence in the company’s abilities to rapidly resolve provider issues. Act as an advisor or thought partner to the organization’s leadership by structuring undefined issues for resolution, researching issues, summarizing information. Working with relevant stakeholders to provide the information needed to make sound and timely decisions. Develop and maintain strong business relationships with internal business partners of all management levels and capabilities. Deliver high quality results on time. Performs other duties as assigned.

Non-Essential Functions:

Other duties, as assigned.

Qualifications:

5-8 years’ experience in a Provider Relations role for managed care. 3-5 years of leadership experience in managing a team. Bachelor’s degree in related field, or at least 4 additional years of experience in healthcare, network development, network management. Managerial key skills include communication, delegation, conflict resolution, decision-making, problem-solving, and the ability to foster a positive and productive work environment. Solid knowledge of health plan operations required.

Physical Requirements:

Mainly sedentary. Sitting at the desk most of the day. Standing or walking less than two hours per day. Lifting no more than ten pounds on rare occasions. Must be able to work at a computer and answer phone calls on a regular basis.

Featured Benefits:

Health, dental, and vision insurance. 401K with automatic employer contribution. PTO and Paid Holidays. Company paid Life Insurance. Access to voluntary short and long-term disability insurance. Access to additional life insurance. Access to a variety of Wellness programs. CareAbout Health is committed to providing an environment of mutual respect where equal opportunities are available to all applicants and employees without regard to actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth, related medical conditions and lactation), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, disability, protected medical condition as defined by applicable state or local law, genetic information, or any other characteristic protected by applicable federal, state, or local laws and ordinances (referred to as “protected characteristics”). We are interested in every qualified candidate who is legally able to work in the United States without sponsorship. We cannot offer any visa sponsorship now at this time. The compensation range for this position is $70K/yr. – $109K/yr. Compensation is based on the level and requirements of the role. Salary within our ranges may also be determined by your education, experience, knowledge, skills, abilities, and location, as required by the role, as well as internal equity and alignment with market data.