Fort Lauderdale, Florida
Manager, Provider Relations Job Opening in Fort Lauderdale, Florida - Job Summary: The Manager, Network Operations is responsible for the day to day oversight of the Network and Provider Relations functions to include research and policy development, contract negotiations for Home Health agencies, Pharmacies and Durable Medical Equipment companies, Network builds in expansion geographies and oversight of all education and orientation of new and existing providers to expansion geographies.
1. Plans, coordinates resources, develops and evaluates work of assigned staff with responsibility to discipline as appropriate and in accordance with company policies, conducts performance appraisals and pay reviews for the Network and Provider Relations staff.
2. Identifies and allocates manpower and resources to assure completion of established objectives within budgetary and schedule guidelines while upholding high customer service standards.
3. Provides on-going contract remediation including assessing delivery of appropriate contract terms and pricing.
4. Oversees effectiveness of network using financial and quality data.
5. Resolves issues and contributes to the business unit/area development including working on difficult problems or situations as necessary for providers and networks.
6. Identifies and initiates network development and provider relations projects and programs that lead to improved processes and products, reduced costs or increased output including maintaining a Quality Assurance Program for the department which includes monitoring department activities.
7. Completes periodic reports and presentations indicating progress of network development and provider relations projects and tasks.
8. Reviews operational procedures to assure maximum efficiency and quality.
9. Assists in the review and evaluation of potential new clients as well as new lines of business.
10. Maintains accurate records and prepares meaningful reports for both internal and external customers.
11. Additional duties as assigned.
Qualifications:
1. Bachelor?s degree in a related field or a minimum of 5 years of industry experience.
2. Minimum of two years of managerial experience in a Network Development or Provider Relations department or comparable homecare operations setting.
3. Proven work record of improving business processes and procedures to maximize efficiency, including a strong data and analytic orientation.
4. Proficient working knowledge of Microsoft software programs (Excel, Word, PowerPoint) and working with system development.
5. Current working knowledge of the insurance industry and its practices is required.
6. Required to uphold the principles of compliance as outlined in the Code of Conduct, Employee Handbook and related policies and procedures. Supports and participates in the mandatory Corporate Compliance Program training initiative on an annual or more frequent basis, as required.
Please only submit your resume if your experience matches the requirements above.
Job Type: Full-time
Required education:
Bachelor's
Required experience:
Manager in Provider Relations: 5 years
Home Health, DME, and Pharmacy: 2 years
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