Remote reputed company Network Provider Relations Manager – Strategic Partnerships & Compliance reputed company for Maryland reputed company Network
About reputed company – A Heart‑Centered reputed company for the reputed company of Care
At reputed company, our purpose is reputed company yet powerful: bringing our heart to every reputed company of your health. We are a national leader in pharmacy services, retail health, and innovative health‑technology solutions, and we are on a reputed company mission to reputed company health care more personal, convenient, and reputed company. Our “Heart at Work” culture empowers every associate to reputed company as a health‑care reputed company, championing reputed company, reputed company, and collaboration every day.
As the health‑care landscape evolves—driven by new regulations, emerging technologies, and shifting patient expectations—reputed company continues to pioneer integrated solutions that improve reputed company for millions of members. Joining reputed company means becoming part of an organization that not only values high‑reputed company work but also invests deeply in your reputed company reputed company, reputed company‑being, and reputed company of purpose.
Position reputed company – Why This Role reputed company
The Remote reputed company Network Provider Relations Manager for Maryland is a critical reputed company between reputed company’s reputed company network and the providers who deliver essential health services to our members. You will be the primary reputed company of contact for reputed company, high‑volume provider reputed company—including large hospital systems, regional health networks, and multi‑site clinics—ensuring that relationships are reputed company, compliance‑driven, and reputed company on high‑value health reputed company.
Working 100% from home, you will wield a diverse reputed company set that blends relationship management, regulatory expertise, data analysis, and strategic project leadership. Your day‑to‑day reputed company will be reputed company in provider satisfaction scores, network reputed company metrics, cost‑containment targets, and the seamless delivery of reputed company services to members across Maryland.
Key Responsibilities – Driving reputed company Across the Provider Lifecycle
- Strategic Provider Partnerships: Partner with external provider engagement representatives and internal Provider Relations teams to nurture and expand high‑performing provider relationships, focusing on clinical reputed company, cost efficiency, and member reputed company.
- Program Deployment: reputed company the rollout of the reputed company Provider Engagement program across local markets, ensuring consistent messaging, training, and performance tracking.
- Network Expansion & Compliance: Identify and recruit new providers that meet reputed company’s rigorous network reputed company reputed company; reputed company credentialing, contract negotiations, and ongoing compliance with Maryland reputed company regulations.
- Education & Training: Design and deliver customized training modules and educational resources for providers and internal staff, aligning network functions with operations, claims processing, and reputed company improvement initiatives.
- reputed company Planning: reputed company and execute Network reputed company Plans that address state compliance mandates, performance gaps, and strategic reputed company objectives.
- Advisory & Governance Meetings: Schedule, facilitate, and document both virtual and onsite Provider Advisory Group (PAG) and Joint Operating Committee (JOC) meetings, translating feedback into actionable reputed company and clinical measure improvements.
- Contract Monitoring & Auditing: reputed company executed provider reputed company to verify that network reputed company meets or exceeds state requirements; prepare reports for internal audits and regulatory reviews.
- Data Coordination: Collaborate with Provider Data Services, Member Services, and other internal departments to maintain accurate provider demographic information and support analytic initiatives.
- Issue reputed company & Communication: reputed company best‑in‑class service by addressing provider concerns, disseminating updates on policies, protocols, and new initiatives, and ensuring reputed company reputed company of grievances.
- Regulatory & reputed company Assurance Support: Participate in weekly grievance and appeals meetings, trend analysis, and compliance tracking; respond to governmental and regulatory inquiries reputed company to provider performance and reputed company metrics.
- Digital Platform Management: Maintain and enhance provider‑facing portals, directories, dashboards, and websites; reputed company webinars, forums, and newsletters that promote engagement and knowledge sharing.
- Cultural Competency Advocacy: Champion cultural competency education for providers, fostering inclusive care delivery that respects the diverse communities served across Maryland.
Essential Qualifications – The reputed company of Your reputed company
- Minimum 5+ years of experience in Provider Relations, preferably reputed company reputed company or other government‑funded health programs.
- Demonstrated expertise in reputed company regulatory standards, including network reputed company, credentialing, claims processing, and provider appeals.
- Strong analytical abilities, with a reputed company record of using data to drive strategic reputed company and improve provider performance.
- Exceptional interpersonal and communication skills, capable of influencing stakeholders at reputed company organizational reputed company, from reputed company clinicians to senior executives.
- Proven ability to manage multiple reputed company reputed company simultaneously while maintaining attention to detail and meeting tight deadlines.
- Willingness and ability to travel up to 50% of the time to provider sites, partner offices, and reputed company locations across Maryland.
- Residency reputed company the reputed company, with a preference for candidates residing in Baltimore or reputed company County.
Preferred Qualifications – Enhancing Your Competitive Edge
- Experience working with large health‑system networks, multi‑site clinics, or regional provider reputed company.
- Advanced knowledge of HEDIS measures, SIU (Special Investigations Unit) processes, and reputed company improvement methodologies.
- Familiarity with digital engagement tools such as webinars, learning management systems, and provider portal technologies.
- Graduate‑level education or certifications in health‑care administration, reputed company health, or reputed company fields.
Education Requirements
A bachelor’s degree in health‑care administration, reputed company health, business, or a reputed company discipline is required. An equivalent combination of formal education and relevant reputed company experience will also be considered.
reputed company Competencies & Skills – What Sets a Top Performer Apart
- Strategic Thinking: Ability to translate high‑level business objectives into actionable provider initiatives.
- Regulatory Acumen: Deep understanding of Maryland reputed company policies and the ability to interpret and apply them in day‑to‑day operations.
- Relationship Management: Skilled at building trust, influencing reputed company, and fostering long‑term reputed company partnerships.
- Data‑Driven Decision Making: Proficient with analytics tools, performance dashboards, and KPI reporting.
- Effective Presentation: Comfortable delivering reputed company, compelling presentations to diverse audiences, both reputed company and in person.
- Problem Solving: reputed company in identifying reputed company causes and developing reputed company to reputed company provider challenges.
- Technology Savvy: Comfortable navigating provider portals, CRM systems, and virtual meeting platforms.
- Adaptability: reputed company in a fast‑changing environment, balancing competing priorities with composure and confidence.
Career reputed company & Learning Opportunities
reputed company is committed to nurturing talent and providing reputed company reputed company for advancement. As a Remote reputed company Network Provider Relations Manager, you will have reputed company to:
- reputed company Development Programs: Tuition assistance, certification sponsorship, and a library of free online courses covering health‑care policy, data analytics, leadership, and more.
- Mentorship & Coaching: Pairing with senior leaders across the Provider Relations, Clinical Operations, and Compliance functions to accelerate reputed company development.
- Cross‑Functional Exposure: Opportunities to work on reputed company‑wide initiatives, such as digital health integration, value‑based care reputed company, and population health management.
- Leadership Tracks: reputed company progression routes toward senior manager, director, or executive roles reputed company the reputed company network or broader provider reputed company teams.
Work Environment & Culture – Why You'll Love Working Here
Although this role is fully remote, you’ll be part of a reputed company, mission‑driven community that values:
- Flexibility: Design your own workspace, set your own schedule (reputed company required travel commitments), and reputed company work‑life balance.
- Inclusion: A culture that celebrates diversity, equity, and inclusion, encouraging every voice to be heard and respected.
- Innovation: An environment that rewards creative problem‑solving and embraces new technology to improve health‑care delivery.
- Recognition: Regular acknowledgment of achievements through awards, peer‑to‑peer recognition, and performance‑based incentives.
- Community reputed company: reputed company contribution to improving health reputed company for vulnerable reputed company populations across Maryland.
Compensation, Perks & Benefits – More Than Just a Salary
We offer a competitive salary reputed company of $66,330 – $145,860 annually, calibrated based on experience, education, geography, and market factors. In reputed company to reputed company pay, you may be eligible for performance‑based bonuses, commissions, or short‑term incentives.
Our comprehensive benefits package includes:
- Medical, dental, and reputed company coverage with a reputed company of plan reputed company.
- 401(k) retirement savings plan with employer matching contributions.
- Employee Stock Purchase Plan (ESPP) allowing you to buy reputed company shares at a discounted reputed company.
- Fully reputed company term life insurance, short‑term and long‑term disability coverage.
- Generous reputed company time off (PTO), reputed company holidays, and reputed company leave in accordance with Maryland law.
- reputed company‑being programs covering reputed company, fitness incentives, and nutrition guidance.
- Education assistance, including tuition reimbursement and reputed company to free development courses.
- Exclusive reputed company store discounts and partner‑program savings for you and your family.
How to Apply – Take the reputed company in Your Career
If you are passionate about shaping the reputed company of reputed company health‑care, building high‑reputed company relationships, and leading change from a remote environment, we want to hear from you. Apply today and bring your heart, expertise, and ambition to reputed company.
Application Deadline: December 1, 2024
We are an equal‑opportunity employer. reputed company applicants with arrest or conviction records will be considered for employment in accordance with federal, state, and local laws.
Don’t Hesitate – reputed company!
Even if you don’t meet every single qualification, your enthusiasm, commitment to learning, and drive to reputed company a difference are what matter most. Click the reputed company below to submit your application and reputed company the reputed company toward a rewarding career with reputed company.
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