Provider Network Services Program Manager Job Lincoln area,Nebraska USA,Healthcare

Summary

GENERAL

SUMMARY:

Responsible for the strategy, development, and management of a best-in-class portfolio of non-clinical services that enhance the value of the Clinically Integrated Network (CIN). This role builds and scales programs and vendor partnerships that improve network performance, operational efficiency, and the value of CIN participation across our diverse membership. This position partners with internal leadership and external vendors to design and implement scalable solutions including service programs, employer-sponsored offerings, delegated credentialing support, and group purchasing initiatives.

PRINCIPAL

JOB FUNCTIONS:

* Commits to the mission, vision, beliefs and consistently demonstrates our core values.

* Develops and maintains a comprehensive network services strategy and prioritized service roadmap informed by ongoing assessment of member needs and organizational objectives.

* Research, evaluates, and recommends new service offerings and vendor partnerships that deliver measurable value.

* Leads the full vendor lifecycle for network service programs including prospecting, due diligence, request for proposal (RFP) development, contract negotiation, implementation, and performance management.

* Manages existing vendor relationships and service contracts, ensuring performance standards and contractual obligations are met; establishes and maintains contract governance and tracking infrastructure.

Identifies opportunities to leverage system resources, including supply chain and group purchasing relationships.

* Leads end-to-end implementation of new service programs, developing project plans, timelines, and workflows that support a consistent launch experience for members.

* Coordinates with the Membership Engagement and Advancement department on member-facing materials and communications.

* Monitors program performance against established key performance indicators (KPIs) including utilization, member adoption, and financial impact; recommends program modifications or discontinuation based on findings.

* Supports the evaluation, implementation, and ongoing management of employer-sponsored insurance solutions available to members and their employees in collaboration with leadership and insurance brokers.

* Serves as the primary liaison between membership and the credentialing department, acts as an advocate for members throughout the delegated credentialing process to ensure a seamless experience and timely resolution of outstanding requirements; monitors and escalates service gaps or compliance concerns to leadership.

* Collaborates with Revenue Cycle, Legal, Finance, Data Analytics, and other internal departments to support program evaluation, contracting, and implementation.

* Ensures network service programs and vendor relationships are designed and managed in accordance with applicable federal and state healthcare regulations.

Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of latest trends in field of expertise.

Participates in meetings,committee sand department projects as assigned.

Performs other related projects and duties as assigned.

(Essential Job functions are marked with an asterisk "*". Refer to the Job Description Guide for the definition of essential and non-essential job functions.) Attach Addendum for positions with slightly different roles or work-specific differences as needed.

REQUIRED

KNOWLEDGE, SKILLS AND ABILITIES:

Knowledge of healthcare network services, vendor management, and program development within a health system or managed service organization (MSO) environment.

Knowledge of employer-sponsored health plan structures, association health plan regulations, and group benefits…