Provider Network Manager Job at North Country Community Mental Health
Serving six counties in Northern Michigan, North Country Community Mental Health is a public behavioral health organization committed to improving the quality of life for people with mental illness and/or developmental disabilities in our communities.
We are currently paying a $1,000 sign on bonus for all employees who have completed six months of continuous employment with us. If you’re interested in joining a welcoming team and creating a rewarding career with excellent benefit package, visit our website to submit your application: http://www.norcocmh.org/careers/ *
- Once you are on our website you need to click on the position and scroll to the bottom of the job description and click apply for this position.
JOB TITLE: Provider Network Manager
LOCATION: Petoskey, MI 49770
REPORTS TO: Chief Operating Officer
STATUS: Full Time, Non-Union
HYBRID ELIGIBLE: Yes
STARTING WAGE RANGE: $58,718 - 61,069 per year
Generous benefit package, including:
- No cost health, dental and vision insurance options
- 14.2% employer paid retirement plan contribution
- Vacation, sick and personal time
- Employer paid disability and life insurance
- Tuition reimbursement programs
- Referral programs
QUALIFICATIONS:
Education: Bachelor’s degree in a human services field, business administration or accounting required
Experience: Previous experience of three to five years in behavioral health. Strong financial background, knowledge of governmental regulations and compliance standards. Familiar with clinical and funding mechanisms of residential placements.
Other: Lived experience with behavioral health issues are valued
SUMMARY OF RESPONSIBILITIES:
The Provider Network Manager works closely with the clinical team to assure contracted network adequacy, quality, compliance, and cost effectiveness. Responsible for maintaining a network composition to support client needs including appropriate living arrangements, professional services, skill building and supported employment. Is responsible for relationship management and oversight of contracted service providers.
ESSENTIAL JOB FUNCTIONS:
- Chairs and Leads Projects of the Residential Sustainability Committee
- Analyzes network adequacy and issues contract RFP/RFQs as appropriate
- Coordinates and facilitates individual provider meetings
- Reviews, tracks, and provides financial approval of residential placements
- Responsible for achieving financial targets of $20M budget
- Assists clinical staff in finding appropriate residential placements
- Leads development and negotiation of residential and day program budgets and rates in close coordination with finance
- Provides oversight to contracted service providers
- Develops policies and procedures to ensure compliance with all laws and regulations including LARA and contracts with the PIHP and MDHHS
- Develops and conducts provider auditing and monitoring activities
- Assures appropriate response to violations and consistent enforcement
- Develops executive level capacity, financial and compliance reports
- Communicates and manages at all levels of the organization including the Board, funders, and management
- Work with the Clinical and Finance Teams to develop Residential Performance Based Measures
PHYSICAL REQUIREMENTS:
Ability to walk, bend, stand, sit, lift up to 25 pounds with or without assistance, stretch/reach, hear, see, hand/finger dexterity. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions in accordance with applicable laws.
OTHER REQUIREMENTS:
- Models the c1C/S vision
- Adherence to the Board’s personnel policies, procedures, and standards
- Adherence and commitment to the principles of community mental health services, and the mission and purpose of North Country Community Mental Health
- Strong problem solving and creative skills; ability to exercise sound judgment and make decisions based on accurate and timely analyses
- Sound business acumen
- Proficient with Microsoft Office products
- Actively participate as a member of teams/committees and offer assistance to others when needed
- Report any situation that is a potential violation of the False Claims Act, or any otherwise reportable occurrence as defined in the Regulatory Compliance Plan
- Maintain good relations with external providers and constructively represent NCCMH in the community
- Maintain a positive attitude with work assignments and in relationships with co-workers.
- Have own smartphone with multi-factor authentication (MFA) capabilities. Use of personal phone may be required to access Agency applications
- Professional written and verbal communication skills
- Possess a valid Michigan driver’s license and have a satisfactory driving record to maintain ability to operate Agency vehicles
- Use of personal vehicle for Agency business may be required when Agency vehicles are not available
- Occasional overnight travel to regional seminars and training
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
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