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Provider Network Manager

Company:
Avidity Exchange LLC
Location:
Minneapolis, Minnesota, United States
Posted:
December 01, 2018

Posted By Premium Recruiter

Description:

Provider Network Manager

Other: Clinical Support

Minneapolis, MN

Full-time

Qualifications

Minimum education

Bachelors

Languages

English

Years of experience

5+ years

**The candidate can live in Minneapolis, Duluth, St Cloud, St Paul**

- Work from your home + field work

The Network Manager (NM) is an integral part of the In-market leadership team.

This individual develops and maintains an ongoing collaborative relationship with providers, based on mutual respect, high quality outcomes and patient satisfaction.

The NM works to continually shape the Network landscape, by offing objective data and education to all stakeholders in the market.

In its highest functional state, they support the provider in ensuring recognition by the hospital and plan partners through appropriate rate setting, improved volume

and achieving and maintaining PAR/Contracted status.

The NM plays a vital role in achieving positive outcomes in the market including but not limited to: SNF LOS, Discharges to PAR/Contracted Providers and Closing

Clinical Records.

- Bachelor's Degree

- 5+ Years in a customer facing or Account Management Role

- Experienced in managed care, health plan operations in provider contracting, customer service, or provider relations

Perks

Travel Reimbursement

Professional development opportunities

Full benefits

401k

schedule details

5 days/week

care settings

Acute

Home Health

Skilled Nursing Facility

- Responsible to develop relationships with providers/payers and supporting the patient centric model during new implementations:

- Creates database of pre-implementation provider metrics (e.g. readmission rates, ALOS, etc.)

- Coordinates of implementation activities (scheduling dates/locations, speakers/attendees, contact points, deck preparation, status updates, etc.)

- Creates plan approved provider facing educational and summary documents

- Ensures all necessary logistics obtained to support a successful implementation (contacts, EMR access, onsite access, etc.)

- Coordinates onsite requirements for naviHealth colleagues (e.g. credentialing, legal requirements, etc.)

- Responsible to maintain positive working relationships with providers/payers to build a high quality, highly receptive network base in mature markets.

- Serve as main point of contact for provider

- Delivers provider and hospital performance information at a regular cadence

- Holds providers accountable to:

- Professional collaboration (based on collaboration agreement)

- Timely delivery of clinical information

- Supporting patient and family access to the nH Care Coordinator

- Evaluates provider receptiveness and quality

- Responsible to lead network issue resolution

- Identifies challenging situations early and ensures appropriate action taken to mitigate escalation.

- Support providers as they have questions / concern / suggestions

- Solicits feedback as appropriate (focus groups, survey, coalitions)

- Works to resolve provider complaints at a local, regional and national level

- Develop ongoing support materials for providers

- Preparation and analysis of dashboards for providers

- Coordination and delivery of dashboard information to providers (SNF and hospital as indicated)

- Provides ongoing education to providers that promotes quality service and collaboration

- Works closely with General Manager and Senior Clinical Manager

- Monitors and works to improve:

- - hospital DC referral patterns

- - par and non-par SNF LOS

- - closed record statistics

- Reports challenges with care coordinators in the field

- May participate in network narrowing strategies

- Works closely with VP Provider Engagement

- Analyzes data for trends in performance on a market, client, regional and national level

- Supports new and existing strategic network initiatives and programs

- Communicates network initiatives to providers

- Supports company specific initiatives as appropriate

- Supports the marketing of the nH brand

- Supports the on-boarding of new network colleagues through mentorship

- Works with internal resources on development of preferred provider networks

- Supports and implements pay for value programs, as applicable

- As indicated, assist with the development contracted networks

- Executing direct contracts with post-acute care providers

- Participating in contract negotiations and contract language review including redlining

- Managing contract load process

Avidity Exchange LLC

https://www.facebook.com/AvidityCareExchange/posts