Manager - Provider Relations (Provider Experience)

Requisition ID:891863

Store #:110342 EM Provider Ops - OH CSC

Position:Full-Time

Total Rewards:Benefits/Incentive Information

At EyeMed, we have a unique perspective on vision benefits. By listening and staying curious, we create innovative vision benefits that are a joy to use.

Our mission is to help people see life to the fullest-and our commitment goes beyond vision benefits. Our passionate employees proudly support the OneSight EssilorLuxottica Foundation, a leading not-for-profit organization with a 100% focus on eradicating the world's vision crisis.

EyeMed is part of EssilorLuxottica, a global leader in the design, manufacture and distribution of world-class vision care products, including iconic eyewear, advanced lens technology and cutting-edge digital solutions. Join our global community of over 200,000 dedicated employees around the world in driving the transformation of the eyewear and eyecare industry. Discover more by following us on LinkedIn.

GENERAL FUNCTION

The Manager, Provider Experience is responsible for developing, managing, and sustaining relationships with a segment and/or region of network of doctors and their staff to drive high levels of network participation satisfaction. This position requires close collaboration with EyeMed cross-functional teams to fulfill provider requests, answer questions, resolve issues and drive overall day-to-day positive experiences. Key areas of focus include executing strategies to maximize provider participation & retention, increase provider satisfaction and ensure compliance with business and regulatory requirements.

MAJOR DUTIES AND RESPONSIBILITIES

• Serve as the account manager & provider relations main point of contact for a segment of independent provider practices participating on the network; manage relationships and is accountable for critical interface with provider offices
• Ensure accurate implementation and day-to-day administration of provider groups, partnering with internal teams such as call center, operations, configuration, sales/account management, recruiting and finance
• Support new network builds and large recruiting projects
• Lead effective provider onboarding and training to use our systems and claim submissions and to service our members with understanding of plan benefits and code procedures
• Conduct ongoing outreach to ensure provider satisfaction and identify issues before escalation
• Work with network providers to address administrative requests, questions and/or issues, such as contracting, claim and billing, payments and credentialing
• Assist in resolving elevated and complex provider service complaints
• Conduct service follow-up when work is complete.
• Develop and maintain key processes established by the business.
• Intake contract negotiation requests and maintain on-going communication with practice during course of review
• Fully understand and ensure operationalization of and compliance with legislative changes as they apply to network management including contracts and processes
• Attend provider conference and/or events annually in coordination with EyeMed events strategy and provider groups collaboration
• Provide complete and timely communication and reporting to manager related to projects in process.

BASIC QUALIFICATIONS

• Bachelor's Degree or equivalent work experience
• 5+ years business experience in relationship management
• Ability to work independently and set agenda for area of responsibility including prioritization of work, scheduling, tasks and projects
• Ability to work under pressure and think critically in regards to operations and administrative processes
• Ability to effectively manage the details of numerous providers simultaneously, set expectations with providers and follows-through on execution
• Excellent verbal and written communication skills and customer service skills
• Working knowledge of Microsoft suite

PREFERRED QUALIFICATIONS

• Experience in network development/management, provider relations, provider operations, call center or sales/account management in health care field
• Knowledge and understanding of plan benefit designs, standards of administration, managed vision care and network options for medicaid, medical and surgical plans
• Working knowledge of private doctor community
• Ability to engage with practices in regards to service reimbursement and negotiations

Employee pay is determined by multiple factors, including geography, experience, qualifications, skills and local minimum wage requirements. In addition, you may also be offered a competitive bonus and/or commission plan, which complements a first-class total rewards package. Benefits may include health care, retirement savings, paid time off/vacation, and various employee discounts.

Upon request and consistent with applicable laws, EssilorLuxottica will provide reasonable accommodations to individuals with disabilities who need assistance in the application and hiring process. To request a reasonable accommodation, please call the EssilorLuxottica SpeakUp Hotline at 844-303-0229 (be sure to provide your name and contact information so that we may follow up in a timely manner) or email HRCompliance@luxotticaretail.com.

We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, gender, national origin, social origin, social condition, being perceived as a victim of domestic violence, sexual aggression or stalking, religion, age, disability, sexual orientation, gender identity or expression, citizenship, ancestry, veteran or military status, marital status, pregnancy (including unlawful discrimination on the basis of a legally protected pregnancy or maternity leave), genetic information or any other characteristics protected by law. Native Americans in the US receive preference in accordance with Tribal Law.