Provider Network Manager

This is a fully remote position, open to applicants in California, +2 more states.

📋 Description

• Develop and sustain robust relationships with providers to enhance engagement, satisfaction, compliance, and performance within the ACO.

• Independently oversee intricate, cross-functional projects.

• Evaluate practice performance and implement strategies to enhance and optimize ACO outcomes across Florida and emerging markets.

• Recognize practice-specific opportunities and convert data into actionable strategies.

• Propel ACO initiatives that align with organizational and market objectives.

• Act as the main point of contact for ACO providers throughout the recruitment, onboarding, education, and process enhancement phases.

• Facilitate both in-person and virtual meetings with physicians, provider groups, and staff.

• Identify enhancements to provider engagement strategies and onboarding processes.

• Monitor provider performance through quality, utilization, referral management, risk, engagement, and team-feedback data.

• Assist HCC improvement activities in collaboration with the coding team for assigned practices.

• Execute provider change-management initiatives at both practice and market levels.

• Coordinate provider education sessions and create workflow-improvement tools and provider profiles.

• Serve as a liaison among Value-Based Care, Business Development, Operations, Quality, and other internal teams.

• Offer data-driven recommendations to leadership.

• Share best practices across markets and align performance initiatives with ACO and organizational goals.

• Perform additional duties as assigned.

⛳️ Requirements

• Bachelor's degree in Healthcare Administration, Business, Finance, or a related field is required.

• A minimum of 5 years of experience in provider network relations, healthcare operations, managed care, or a related field.

• Preferred experience in provider relations and ACO environments.

• Proven track record of analyzing data and making recommendations that influence business or operational outcomes.

• Valid driver's license and the ability to travel within the Florida service area and occasionally to the West Coast.

• Demonstrated capability to exercise independent judgment and discretion in assessing provider opportunities for ACO performance enhancement.

• Strong analytical skills with the ability to interpret data and convert findings into actionable strategies.

• Understanding of value-based care and the capability to address gaps in provider understanding.

• Familiarity with CMS, Medicare, and ACO regulatory requirements.

• Ability to influence stakeholders and foster relationships with providers and internal partners.

• Excellent communication and presentation skills.

• Capacity to manage multiple priorities and adapt in a dynamic, fast-paced setting.

• Proficient in Microsoft Office and data/reporting tools.

🏝️ Benefits

• Full-time remote position.

• Opportunities for travel and fieldwork across Florida, with travel to California and Nevada as necessary.

• Equal Employment Opportunity and Affirmative Action employer.

• Reasonable accommodations provided for applicants with disabilities.