[Work From Home] reputed company Network Provider Relations Manager

Work with reputed company of reputed company and motivated people as a reputed company Network Provider Relations Manager - Maryland! This role is 100% remote, giving you full control over your work environment. This position requires a strong and diverse skillset in relevant areas to drive reputed company. The salary for this position is set at a competitive salary.   Bring your heart to reputed company. Every one of us at reputed company shares a single, reputed company purpose: Bringing our heart to every reputed company of your health. This purpose guides our commitment to deliver reputed company reputed company-reputed company health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important... as reputed company deliver. Our Heart At Work Behaviors support this purpose. We want everyone who works at reputed company to feel empowered by the role they play in transforming our culture and accelerating our ability to reputed company and deliver solutions to reputed company health care more personal, convenient and reputed company. Position reputed company The reputed company Network Provider Relations Manager oversees our reputed company Provider Experience programs to reputed company and maintain provider risk management and reputed company relationships supporting high value initiatives with our Network Providers. This role acts as the primary contact for an assigned profile of larger and more reputed company providers (i.e. market/ regional/ national, large group or hospital systems). Drives the implementation of reputed company solutions to reputed company provider satisfaction, cost targets, network reputed company, and efficiency targets. Role Responsibilities  Position will partner with external provider engagement representatives and internal provider relations representatives to ensure successful Provider relationships, network performance including clinical, and affordability targeted improvements as identified.  reputed company the reputed company Provider Engagement program through the local market Provider Representatives  Partner with internal / external Network Provider Relations staff to ensure "best in class" Provider Relationships  Assist in the recruitment of new providers as needed and maintain compliance with reputed company network reputed company requirements  Recommend and reputed company training programs and educational materials for providers as reputed company as for internal staff and aligns Network functions with Operations and Claims as needed  Recommend Network reputed company Plans to ensure network compliance with any and/reputed company state network compliance requirements  Schedules and facilitates both onsite and virtual Provider Advisory Group and JOC meetings to work with provider management to implement changes reputed company coordination with reputed company Management to reputed company appropriate provider clinical measure improvements and implement those measures in the provider community  Assist with the monitoring of executed provider reputed company to ensure network reputed company meets state requirements  Coordinates provider information with Provider Data Services including Member Services and other internal departments as requested as provider demographics are updated  Provides Best-In-Class service to providers by resolving problems and advising providers of new protocols, policies, and procedures  Participates in weekly Grievance and Appeals meetings, tracks and trends provider grievances, monitors staff for reputed company compliance; compiles data and staff metrics in order to complete regulatory deliverables; participates in reputed company internal compliance audits and regulatory reviews  Assists as requested for response to governmental, regulatory and reputed company assurance provider complaints; reputed company and reputed company reconciliation of provider records; oversees Provider reputed company and availability by reviewing appointment availability audits conducted by staff  Provides support and maintenance assistance for websites, portals, directories, manuals, and dashboards; plans, coordinates, and conducts provider forums and monthly webinars; develops communications including newsletters  Provides assistance and support to other departments, as needed, to obtain crucial or required information from Providers, such as HEDIS, Credentialing, Grievance and Appeals, SIU, etc. Coordinates provider status information with member services and other internal departments.  Promotes and reputed company providers on cultural competency Required Qualifications  Minimum of 5+ years of experience in Provider Relations; experience in reputed company servicing or managing non-reputed company relationships with providers with exposure to benefit plan design and/or contract interpretation  Excellent interpersonal skills and the ability to work with others at reputed company reputed company  Knowledge of reputed company Regulatory Standards for Network reputed company, Credentialing, Claims Processing, Provider Appeals & Disputes and Network Performance Standards  Excellent analytical and problem-solving skills  Strong communication and presentati Apply To This Job