Network and Provider Relations Manager

** Network and Provider Relations Manager
**** Communi Care Advantage**, a member of
** Communi Care Health Services**, is currently recruiting a
** Network and Provider Relations Manager
** to support our
** Medicare Advantage
** plan in the state of
** Virginia**.
** PURPOSE/BELIEF STATEMENT
** The Network and Provider Relations Manager is responsible for the execution of a strategic plan to recruit, service and support network providers in an assigned geographic area.
** BENEFITS
* * As a Communi Care employee you will enjoy competitive wages and PTO plans. We offer full time employees a menu of benefit options from life and disability plans to medical, dental, and vision coverage from quality benefit carriers. We also offer 401(k) with employer match and Flexible Spending Accounts.
** QUALIFICATIONS AND EXPERIENCE REQUIREMENTS
*** Bachelor's degree and a minimum 5 years of experience working in network management and/or provider relations.
* Must have a working knowledge of Medicare programs.
* Must possess solid knowledge and understanding of managed care industry; and local market conditions.
* Proficiency in MS Office Suite
* Must possess valid driver's license.
* Must be willing to travel within the service area at least 50% of the time
** KNOWLEDGE/SKILLS/ABILITIES
*** Must have integrity and a strong ethical compass.
* Must be flexible, able to work independently, and able to achieve deadlines and deliverables with minimal supervision.
* Must have strong communication skills and ability to work effectively with people coming from diverse cultural and professional perspectives.
** JOB DUTIES AND RESPONSIBILITIES
*** Develop the provider network through contract negotiations, relationship development, and servicing all provider types.
* Develop and maintain positive provider relationships with provider community by regular on-site visits (may be virtual or in person as needed), communicating administrative and programmatic changes, and facilitating, education and the resolution of provider issues.
* Serve as a knowledge and resource expert regarding the most complex provider issues impacting provider satisfaction, research and resolve the most complex provider issues for prompt resolution.
* Provide assistance regarding education, contract questions and non-routine claim issues.