Director, Provider Relations
- Work closely with the Vice President to develop and implement a comprehensive provider relations strategy to foster strong partnerships with key providers and retail providers, including a strategic plan for network reimbursements.
- Act as liaison between the NVA and healthcare providers, addressing inquiries, concerns, and feedback.
- Creation and maintenance of a customer service model for internal and external customers.
- Identify opportunities for new partnerships and negotiate contracts with healthcare providers with the Vice President.
- Analyze market trends and provider network performance to inform strategic decisions.
- Ensure compliance with regulatory requirements, as applicable and industry standards.
- Management of on-going provider communications (ECP and Retail).
- Initiates and implements processes of ensuring the website and provider directory accurately contains current information.
- Creates and maintains databases for enrollment, complaints, etc. and provides trend analysis.
- Creates Policies and Procedures that control the network functions.
- Communicates pertinent provider issues to applicable internal customers and the Vice President.
- Creates and maintains all provider manuals.
- Development of templates and management of Plan Sheets, including creation of manual sheets.
- Provider wake up process, including the drafting and coordination of mailing letters, based on group demographics.
- Ownership of any Internal Improvement Plans (IIPs) related to department functions.
- Oversees multiple projects simultaneously.
- Other duties as assigned.
- Bachelor’s degree in business or related health care management field. Significant additional experience can be considered in lieu of a degree with some college.
- 5 years’ minimum experience in Network Management and Relationship Development of Health Care Plans and Providers in a capacity of a managed care or vision company.
- Excellent oral and written communication skills and able to communicate effectively with all customers.
- Computer skills with Microsoft office and with experience in MS Word, Excel, PowerPoint, Access and exchange or outlook email.
- Demonstrated leadership skills.
- Demonstrated strong organizational, analytical and problem-solving skills.
- Ability to multi-task, shifting back and forth effectively among multiple activities.
- Travel as required.
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