Manager, Provider Network Operations

Job description

FLSA Status: Exempt Department: Provider Network Operations Reports To: Director, Provider Network Operations GENERAL DESCRIPTION OF POSITION: The Manager, Provider Network Operations is responsible for providing day-to-day management and leadership of the Provider Network Operations team responsible for establishing and maintaining excellent relationships with SCFHP’s provider network. This involves the development and execution of strategies related to communication, outreach, training, education, and service to the SCFHP provider network. The Manager designs and implements programs to build and nurture positive relationships with providers, staff and leadership of contracted health plans, physicians, hospitals, ancillary providers, IPAs, various types of health care facilities, and non-traditional medical providers. Responsibilities include conducting outreach to build relationships, conducting initial and subsequent provider orientations and ongoing training, troubleshooting concerns related to the provider’s contract or operational issues, and implementing ongoing quality and service improvement initiatives in support of a positive member and provider experience. In addition t...