Centers Plan for Healthy Living

  • Provider Network Manager

    Job Locations US-NY-Staten Island
    Posted Date 8 months ago(3/6/2018 11:32 AM)
    # of Openings
  • Overview

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    Under the direction of the Assistant Director of Provider Contracting & Credentialing, the Provider Network Manager is responsible for managing all aspects of the Network Contracting, Credentialing and Provider Services functions for the Network Management Department. This includes managing the onboarding of new providers and practitioners along with ongoing email and phone support to address issues and concerns




    • Develops and manages provider contracting efforts and partnerships to achieve quality, cost management and strategic business development objectives.
    • Monitor local market trends relative to provider contracting and reimbursement, maintain a pulse on industry trend, make recommendations to modify current processes and lead or assist with implementing changes as necessary.
    • Develop and maintain process, systems and explicit measures that ensure timely and accurate execution of contracting objectives.
    • Utilizes creative and innovative approaches in introducing new processes or evaluating existing activities
    • Responsible for ongoing communication with the Assistant Director of Provider Contracting & Credentialing about key projects, goals, challenges and barriers to assure timely and effective issues escalation.
    • Participate in the annual strategic planning process and develop and meet performance goals relative to the strategic plan.
    • Responsible for proactive collaboration with other internal departments on resolution of escalated or complex issues, complaints, grievances or risk issues.
    • Responsible for supervision of direct reports to include performance management and evaluations.
    • Lead by example encouraging a positive working environment and a “team” attitude.
    • Support staff and provide the tools and resources they need to accomplish their goals which includes ensuring staff understand their roles and support staff in addressing issues that arise.
    • Responsible for developing, training, mentoring and retaining high quality, productive employees.





    • Bachelor’s Degree in Business, Finance or a related field; or a minimum of 5 years’ provider relations experience



    Type of Experience                                         

    • Solid leadership/management experience including supervisory and teambuilding.
    • Strong financial acumen with proficiency in analyzing and interpreting financial trends in the provider contracting arena.
    • Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information form others.


    Specific Technical Skills


    • Comprehensive knowledge of advanced managed care principles including risk contracting, value-based contracting, and capitation.





    Knowledge and Skills:

    • Strong work ethic
    • Strong management and leadership skills
    • Strong communicator
    • Ability to solve problems and drive issues or projects to conclusion
    • Ability to function at a tactical level with a “hands on style”
    • Highly motivated, self-directed leader
    • Ability to work collaboratively across the organization
    • Ability to translate policies into daily routine operations
    • Ability to effectively delegate





    # Direct Reports:                                



    The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.


    The above statements are intended to describe the general nature and level of work performed by individuals assigned to the job classification.  They should not be construed as an exhaustive list of all responsibilities, duties and skills required.


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