Job Title: Provider Relations Manager

Reports To: VP, Contracting and Provider Network

FLSA Status: Non-Exempt

Department: Network

Summary:

Work with prospective Altus ACE providers and successfully navigate them through the contracting process. Act as liaison between the Altus ACE and providers and their support staff on various issues related to administration of provider contracts, including education and training, issue resolution, and other activities. Responsible for building strong interpersonal working relationships with Altus ACE providers and support staff; ability to utilize problem solving skills to resolve issues in addition to performing duties.

Essential Duties and Responsibilities

• Orient contracted providers to Altus ACE programs and systems.
• Conduct visits to provider sites and respond to provider network issues.
• Maintain and update provider databases within Salesforce.
• Create Provider specific action plans to address key issues in clinical care and financial categories.
• Support the various provider types including hospitals, physicians, and ancillary providers in implementation of contracted proposals.
• Support the credentialing process to ensure all provider documents are completed.
• Act as a liaison between health care providers and the Altus ACE network team.
• Field routine questions from members with respect to managed care issues.
• Provide training and support to providers and their staff.
• Collaborate with the Contract Manager on identifying providers for growth strategies.
• Training on provider facing tools supported by Altus ACE.
• Serves as a resource for Physicians, answering questions and providing information about network procedures or contracts.
• Monitor provider performance and resolves any issues.

Qualifications:

• Bachelor’s degree in related field required.
• 3+ years of provider relations experience in the healthcare field required.
• At minimum, three years of physician and hospital contracting experience required.
• Strong understanding of Medicaid and Medicare Plans.
• Experience negotiating managed care contracts a plus.
• Strong analytical and computer skills required.
• Proficient Microsoft Suite knowledge
• Must have strong negotiation skills, highly professional, with outstanding interpersonal and communication skills (both written and verbal).
• Demonstrated experience with managing and cultivating strong business relationships with provider community.
• Ability to manage multiple projects simultaneously.
• Ability to manage data and processes in multiple claims platforms.
• Working knowledge of Salesforce and Microsoft Power BI is a plus.
• Ability to read, analyze, and interpret contracting journals, financial reports, and legal documents.
• Have working knowledge of Word Processing and Spreadsheet software. Database and project management software knowledge a plus.

Reasonable Accommodations:

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Job Type: Full-time

Pay: $60,000.00 - $80,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Education:

• Bachelor's (Required)

Experience:

• Microsoft Office: 3 years (Preferred)
• Provider Relations: 3 years (Required)
• Healthcare: 3 years (Required)

Work Location: On the road

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