Manager Provider Relations - JHP

Job Details

Job Description

• Ensure network providers receive high-quality service from the Provider Relations team. Track and measure performance against established departmental metrics and KPIs.
• Develop and manage relationships with network partners to ensure satisfaction, retention, and performance.
• Serve as the primary liaison between the organization and providers/vendors to resolve issues and implement strategies.
• Work with team to conduct regular meetings and site visits with network entities to review performance, address concerns, and support engagement.
• Monitor network performance metrics and ensure compliance with service level agreements (SLAs), policies, and standards.
• Recruit, develop, motivate and retain a high caliber of team members
• Participate in the negotiation of contract terms with network partners, including rates and performance expectations. Maintain thorough knowledge of all provider contracts (e.g., physician, ancillary)
• Identify opportunities to improve network adequacy, efficiency, and value. Develop provider retention strategies for designated territories.
• Interact with various departments to resolve provider issues, including coordinating resolution.
• Collect and report statistics related to number of provider issues/concerns received, number of site visits completed, and other departmental metrics/KPIs as assigned.
• Work to develop and modify desktop procedures and training materials that ensure consistent "best practice" performance for new and existing employees.
• Perform other duties and special projects as assigned.

Education:

• Bachelor's degree in Business, Healthcare Administration, Public Health, or a related field (Master's preferred).

Experience:

• 5-7 years of progressive experience in network relations, provider contracting, or healthcare/insurance operations.
• 2+ years in a supervisory or management capacity with demonstrated leadership success.

Work Shift

Worker Sub Type

Primary Location Address

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.

Benefits

At Jefferson, we offer a comprehensive total rewards package designed to support the health and well-being of our colleagues and their families. It includes a wide range of benefits including competitive pay, health and retirement benefits, life and disability insurance, paid time off, educational benefits, financial and mental health resources and much more. Our diverse benefits offerings ensure you have the coverage and access to services you need to thrive both personally and professionally.