Location and Schedule: Houston, TX | Full-time | 100% onsite | Monday through Friday, 9:00 a.m. to 6:00 p.m.
Description:We are seeking an experienced Provider Network Manager to support provider relations, network development, and organizational growth. The Provider Network Manager serves as the primary provider-relations contact for assigned territories, which may change based on business needs. This individual works closely with the Network Development team to introduce the organization to prospective providers and secure participation agreements in accordance with company policies and procedures.
The Provider Network Manager also plays a critical role in expanding the organization's presence among providers by identifying, researching, evaluating, and developing relationships with providers who align with its network strategy. This position reports to the Senior Director of Provider Network.
What You Will Do:- Manage provider-relations and provider-liaison responsibilities within assigned territories.
- Conduct initial provider outreach and telephone communications to assess interest and determine eligibility for contracting.
- Identify and research IPA, medical group, and provider leads for new service areas and specialty-network gaps.
- Develop a strong understanding of local market conditions, including whether practices belong to larger systems that contract as single entities.
- Participate in quarterly Joint Operating Committee meetings and provider in-service sessions.
- Assist providers with eligibility, member benefits, and other provider-related questions or issues.
- Collaborate with executive leadership on network strategy, program development, provider recruitment, contracting, and onboarding initiatives.
- Build and maintain an adequate provider network within assigned geographic areas.
- Maintain provider relationships and manage provider-relations activities until responsibilities are transitioned to the local network team.
- Provide regular updates to leadership regarding progress, risks, and potential opportunities within assigned areas.
- Monitor network performance and develop business solutions that address process and quality gaps.
- Communicate network strategy, planning, and performance expectations.
- Provide vendor oversight.
- Travel as required.
- Complete special projects as assigned.
You Will Be Successful If:- You can manage and prioritize multiple responsibilities in a fast-paced, start-up environment.
- You promote teamwork and use facts and data to guide decisions.
- You communicate clearly and professionally with providers, leadership, vendors, and internal teams.
- You can work independently while also contributing effectively within a team.
- You demonstrate strong attention to detail.
- You possess critical listening, analytical thinking, and problem-solving skills.
- You can train, teach, and guide others effectively.
- You demonstrate strong strategic-management and time-management skills.
- You maintain professional telephone etiquette.
- You remain resilient and adaptable in a changing environment.
- You have demonstrated increasing levels of leadership and responsibility.
- You have a proven ability to build, develop, and lead strong operational teams.
What You Will Bring:- A bachelor's degree in business, economics, healthcare administration, or a related field is preferred.
- A master's degree or equivalent advanced education is preferred.
- At least five years of managed-care contracting experience, including provider relations or provider-network development.
- Experience with bundled-payment contracting, risk-based arrangements, or capitation.
- A proven record of successful negotiations and meeting leadership, including developing agendas and achieving defined goals.
- Knowledge of network-management processes and services.
- Familiarity with the healthcare industry.
- Proficiency with Microsoft Office and intermediate computer skills.
- The ability and willingness to travel.
- The ability to work onsite full time from 9:00 a.m. to 6:00 p.m.
