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Manager, Provider Network

Brighton, MA 02135

Posted: 06/10/2024 Employment Type: Direct Hire Job Number: 42036 Pay Rate: 175,000

Job Description

Job Summary:
The Manager of Provider Relations is responsible for overseeing all aspects of provider contract management, credentialing processes, and database systems to ensure efficient and effective provider relations operations. This role involves resolving issues promptly, maintaining strong relationships with healthcare providers, and ensuring compliance with regulatory standards.
Key Responsibilities:
Provide strategic input identifying contracting opportunities to support network adequacy requirements
Contract Management:
  • Develop, negotiate, and manage contracts with healthcare providers, ensuring all terms meet company standards and regulatory requirements.
  • Monitor contract performance and compliance, making necessary amendments to address any issues.
  • Collaborate with legal and finance teams to ensure contracts are accurate and financially sound.
Credentialing:
  • Oversee the credentialing process for all providers, ensuring timely and accurate verification of qualifications and licensure.
  • Maintain up-to-date records of provider credentials and ensure compliance with internal and external standards.
  • Implement best practices for credentialing and continuously seek to improve processes.
Database Systems:
  • Manage and maintain provider databases, ensuring data integrity, accuracy, and confidentiality.
  • Develop and implement systems for tracking and reporting provider information.
  • Ensure database systems are up-to-date and comply with relevant regulations and standards.
Issue Resolution:
  • Act as the primary point of contact for resolving provider issues, including contractual disputes, payment discrepancies, and credentialing concerns.
  • Implement processes to track, manage, and resolve issues efficiently.
  • Collaborate with internal teams and providers to develop solutions that foster positive relationships and outcomes
Requirements:
Minimum Education: Bachelor's
Minimum Management Experience: 5 years

Meet Your Recruiter

Ashley Dineen

Ashley Dineen has been with The Panther Group since 2009 and has worked within many areas of the company including payroll, compliance, on-boarding, recruitment, and client management.

Ashley is a mother of two and enjoys spending time with family in her spare time.

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About Brighton, MA

Discover exciting job opportunities in the vibrant city of Brighton, Massachusetts! Located just a stone's throw away from Boston, this charming neighborhood boasts a unique blend of historic architecture, trendy boutiques, and diverse dining options. With easy access to renowned art galleries, theaters like the Brighton Music Hall, and professional sports teams such as the Boston Celtics, job seekers in Brighton can experience a rich cultural tapestry while advancing their careers. Explore job listings in Brighton today and unlock endless growth possibilities in this enchanting city!
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