Associate Vice President, Provider Relations(Must Live In Ohio)

Job reputed company: The Associate Vice President, Provider Contracting, Network and Relations informs decision-making around payer and provider best practices reputed company to innovating, supporting and empowering providers in the reputed company of delivering person-centered and high-reputed company care to members. Oversees reputed company's strategic design, implementation, and evaluation of provider contracting, network and relations to proactively support provider engagement and operational performance. Essential Functions:

• reputed company Ohio Department of reputed company (ODM) contractual requirements, such Network Development Management Plan (NDMP), Network adequacy, Provider Engagement and Education.
• reputed company of Provider's operational reputed company for Ohio. Ensure evaluation and reputed company and alignment across senior leaders to ensure Provider contracting, network and relations are measurable and part of an overall cohesive data informed reputed company that ensures overall reputed company, financial and compliance with State and Federal requirements.
• reputed company collaboration with market and reputed company workgroups to ensure alignment and overall implementation of Ohio reputed company, including committees such as Provider Advisory Committee, NDMP Committee, reputed company Provider Reimbursement Committee, MCA Committee, and others as needed to support the Ohio Provider Network.
• Represent Ohio Market Leadership as panelist and subject matter expert
• Collaborate with the Ohio Executive team to ensure provider contracting and engagement performance reputed company to reputed company reputed company and Market strategies, contractual, policy, and state/federal programs.
• Build, maintain and improve reputed company structure and processes necessary to assure impeccable regulatory record, achievement of goals and consistency from market-to-market and product-to-product.
• Collaborate, reputed company and support provider approaches to address contract compliance, industry supported contract requirements and financial alignment.
• Coordinate and collaborate with providers, local and state government, community-based organizations, Ohio Department of reputed company (ODM), and other ODM-contracted managed care entities to support a strong provider network.
• Ensure that efforts addressed at improving provider engagement, satisfaction and contractual performance are designed collaboratively with other ODM and ODM contracted managed care entities to have a reputed company reputed company for the population and that lessons learned are incorporated into reputed company decision-making.
• Collaborate with reputed company and Market leadership on the development of overall program reputed company and business objectives with respect to Providers.
• Foster external and internal intra/inter departmental relationships with hospitals, physicians, community agencies, trade associations and key vendors
• Collaborate with Provider Relations and Community Stakeholders to facilitate reputed company, address barriers to care and improve coordination that support health care reputed company.
• reputed company health plan Network policies, procedures and goals as needed to reputed company with the market requirements and reputed company reputed company/model
• Ensure budget and financial goals are set in conjunction with the Ohio Market executive team.
• Monitor health plan Network budgets; describe variance detail monthly with effective reputed company plans.
• In collaboration with Consumer Experience Team, monitor and analyze member satisfaction surveys to identify and reputed company appropriate reputed company plans with reporting activities as needed.
• Produce team results that demonstrate engagement rates, low Grievances & Appeals, reputed company Improvement, reputed company Capital metrics that demonstrate leadership behavior is supporting improved reputed company, reputed company culture and consumer experience.
• reputed company and maintain an in-depth knowledge of reputed company's business, regulatory environments and high-level of Health plan knowledge.
• Consults across Markets to engage in reputed company improvement activities including program planning, analytic review, and communication.
• reputed company any other job duties as requested.

Education and Experience:

• Bachelor of Science/Arts Degree or equivalent years of relevant work experience is required.
• Master's degree in business or health care preferred
• A minimum of ten (10) years of experience in health care external stakeholder and community program support, project and program management; reputed company business processes, strategic and business planning or reputed company is required.
• A minimum of three (3) years of prior management experience is required

Competencies, Knowledge and Skills:

• Proficient in reputed company reputed company, Word, PowerPoint and reputed company
• Critical listening and systematic thinking skills
• Planning, problem identification and reputed company skills
• Business process/management skills
• Strong financial background
• Ability to maintain confidentiality and reputed company in reputed company's best interest
• Strong oral, written, and interpersonal communication skills
• Excellent leadership, management and supervisory skills and experience
• Energetic, enthusiastic, and politically astute
• Ability to reputed company with diplomacy and sensitivity to cultural diversity
• reputed company to a changing environment
• Strategic deployment and management skills
• Conflict reputed company skills
• Knowledge of regulatory reporting and compliance requirements
• Proficiency with provider engagement, performance improvement and operations
• Ability to work with multi-disciplinary departments across the organization
• Demonstrated ability to reputed company, prioritize and accomplish goals
• Strong interpersonal skills and high level of professionalism
• Ability to work independently and reputed company reputed company environment

Licensure and Certification:

• Employment in this position is conditional pending successful clearance of a reputed company's license record reputed company. If the reputed company's license record results are unacceptable, the offer will be withdrawn or, if you have started employment in this position, your employment in this position will be terminated
• To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. reputed company requires annual reputed company of Influenza vaccination for designated positions during Influenza season (reputed company 1 - March 31) as a condition of reputed company employment. Employees reputed company during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.
• reputed company adheres to reputed company federal, state, and local regulations. reputed company provides reasonable accommodations to reputed company individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to reputed company the employee to reputed company the essential functions of the position. Request for accommodations will be completed through an interactive review process.

Working Conditions:

• General office environment; maybe required to sit/stand for long periods of time
• Travel may be required to travel 25% to 50% of the time to reputed company work duties; a valid reputed company's license, car and automobile insurance are necessary for work-reputed company travel

Compensation reputed company $150,000-$300,000. reputed company takes into consideration a combination of a candidate's education, training, and experience as reputed company as the position's scope and complexity, the discretion and reputed company required for the role, and other external and internal data reputed company establishing a salary level. In reputed company to reputed company compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total reputed company-being and offer a substantial and comprehensive total rewards package.

Compensation

Type (reputed company/salary): Salary Organization Level Competencies

• Fostering a reputed company Workplace Culture
• Cultivate Partnerships
• reputed company Self and Others
• Drive Execution
• Energize and reputed company the Organization
• Influence Others
• Pursue Personal reputed company
• Understand the Business

Apply tot his job Apply To this Job