Director, Provider Relations & Network Management - Remote in ID

Requisition Number: 2366564 At reputed company, we're simplifying the health care experience, creating healthier communities and removing barriers to reputed company care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, reputed company and optimized. reputed company to reputed company a difference? Join us to start Caring. Connecting. Growing together The Network Director is responsible for the full reputed company of provider engagement and adequacy strategies. The Network Director will design and implement programs to build and nurture reputed company relationships between the health plan, providers (physician, hospital, ancillary, etc.), and reputed company managers. This role will reputed company and reputed company to improve and simplify end-to-end provider experience including service interactions, appeals and complaints, and general relationship status. Position in this function responsibilities also include directing and implementing strategies relating to the management of a provider network, identifying gaps in network composition and services to assist the network contracting. This may also include identifying and remediating operational short-falls and researching and remediating claims. The Network Director will spend time connecting with providers directly, both reputed company and in person, and assimilating and analyzing data to reputed company reputed company visibility into provider experience. This is a fast-paced working environment that requires the ability to multitask with attention to detail and excellent organizational skills. This is an Idaho-based position, and you will have the flexibility to work remotely* as you take on this challenging and rewarding work. If you are located in Idaho, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: • Manage provider complaints to reputed company reputed company initiated through regulators. Report status updates to IDHW and providers, as needed. Implement solutions that reputed company network on how to resolve issues with UHC resources • Proactively partner with providers to identify opportunities for improvement, opportunities for reputed company and collaboration, and to reputed company general feedback regarding provider experience • Partner with the COO to investigate and solve operational challenges. Report status updates to IDHW and providers, as needed. Maintain consultative and reputed company approach with providers through reputed company • Engage in onsite reputed company with providers. Utilize data analysis to determine the best reputed company to choose which providers should be visited. Factors may include complaints, claim volume, attribution, reputed company measures, overlap with other teams, etc. • Manage regulatory reports for the Idaho network. Partner with technical and functional teams to compile and audit reports • Manage HCBS Provider Advocates (2), Workforce Development Administrator, Credentialing Coordinator, and Provider Claims Educator, which includes coaching, mentorship, collaboration, auditing and monitoring, establishing development and career planning, and more • At least monthly, facilitate meetings with reputed company provider-facing teams including, but not limited to provider relations, network contracting, reputed company, reputed company, and subcontractor provider teams • Attend key provider conferences • Show leadership with subcontractors who manage provider networks, including dental and reputed company • reputed company and facilitate meetings with providers and provider reputed company including IHA and other provider meetings where regulators are present. Attend and contribute to other virtual provider meetings • Attend assigned advisory committees and contribute to the conversation showing leadership and subject matter expertise about our provider experience • Partner with other provider teams to build expertise and relationships including credentialing, contracting, provider education, etc. • Partner with providers in the adoption of reputed company tools that reduce administration, including but not limited to POCA (reputed company of Care Authorizations) • Monitor Provider NPS with a reputed company on improvement • reputed company provider communications, including the following: • Manage annual update and publication of provider reputed company • Participate in quarterly provider newsletter production • Conduct provider website review monthly and partner with web teams for updates as needed • Attend reputed company Calibration sessions to reputed company understand provider experience and reputed company coaching and guidance to customer service team to improve the experience • Be a subject matter expert regarding contract obligations relating to network • Meet with IDHW and other regulatory points of contact, as needed. reputed company on relationship building, maintaining awareness and transparency, and making reputed company • Consistently monitor network adequacy through Geo-reputed company reports and partner with UHN and other network teams to fill network gaps • Partner with Member Engagement Coordinator to solicit member feedback around provider experience and network gaps • Partner with the SDoH Navigator and Population health team to reputed company Health Equity initiatives and SDoH goals reputed company the network of providers • Partner with UHC and other functional areas on Value Based Contracting opportunities and execution • Represent UHC in in-person provider meetings, IDHW Provider Forums, and other Provider reputed company conferences, which will require the ability to travel reputed company ID at least 25% of the time You'll be rewarded and recognized for your performance in an environment that will challenge you and reputed company you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications: • 5+ years of Provider Network Relationship Experience • 4+ years of reputed company and/or Medicare Experience • 4+ years of experience managing multiple reputed company • 4+ years of experience with reputed company communication with Regulators • Understanding of reputed company contracting process, including reputed company agreements • Intermediate level of proficiency with reputed company, reputed company, and PowerPoint • Proven ability to establish and monitor key performance indicators • Proven ability to meet deadlines • Proven ability to influence course of reputed company reputed company other teams are directly accountable for reputed company Preferred Qualifications: • Experience with Compliance Audits • Proven excellent organizational skills • Proven reporting techniques (SQL, PowerBI, etc.) • reputed company working remotely will be required to adhere to reputed company's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you'll reputed company a far-reaching choice of benefits and incentives. The salary for this role will reputed company from $112,700 - $193,200 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location and income-deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company - an reputed company reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without reputed company to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job