Provider Relations Manager - Program Implementation - Provider Network

Unclassified - South San Francisco, CA

Full-time

South San Francisco, CA

About the position

The Provider Relations Leadership Manager will play a crucial role in the expansion implementation and solution development of a provider network. This position involves overseeing the credentialing process, selecting, training, and supporting the team, as well as ensuring compliance with NCQA certification standards. The manager will be responsible for developing strategies to enhance provider relations and improve overall network performance. This role requires a strong understanding of managed care and commercial plans, as well as the ability to lead a team effectively in a fast-paced environment. The ideal candidate will have a passion for healthcare and a commitment to fostering positive relationships with providers to ensure high-quality care delivery.

Responsibilities

• Oversee the credentialing process for providers within the network.
• Select, train, and support the team responsible for provider relations.
• Ensure compliance with NCQA certification standards.
• Develop and implement strategies for provider network expansion.
• Foster positive relationships with providers to enhance network performance.
• Monitor and evaluate the effectiveness of provider relations initiatives.

Requirements

• Bachelor's Degree in Healthcare or a business-related field.
• A minimum of five years of experience in managed care and commercial plans.