Community Supports Provider Relations Manager at IEHP developing and maintaining healthcare provider networks for service adequacy and compliance. Leading onboarding and engagement efforts in support of quality initiatives.
Responsibilities
Responsible for developing and maintaining a robust network of potential and contracted Community Supports network providers to ensure service adequacy, quality, and compliance with federal, state, and local regulations.
Serves as the primary liaison and subject matter expert for all CS services associated with their assigned providers, fostering strong partnerships to drive operational excellence.
Lead provider engagement, onboarding, training, and performance improvement efforts.
Support strategic initiatives to expand and strengthen the Community Supports network in alignment with IEHP’s mission and strategic goals.
Recruit new CS Providers into IEHP Community Support Network as well as identify opportunities to develop the Community Supports network to meet IEHP quality metrics, service goals, and compliance standards.
Requirements
Three (3) or more years of experience with customer service in a health services setting including Hospital, Managed Care, Medical Group, IPA, and/or HMO
Experience with managed care
Experience working in the community with community-based organizations (CBO’s)
Bachelor's degree from an accredited institution required
In lieu of the required degree, a minimum of four (4) years of additional relevant work experience in Community Supports is required for this position.
Master’s degree from an accredited institution preferred
Must have a valid California Driver’s license and valid automobile insurance.
Must qualify and maintain driving record to drive company vehicles based on IEHP insurance standards of no more than three (3) points.
Knowledge of Community Support Services
Working knowledge of Medical Group, IPA, CBO’s and HMO operations
Proficiency in utilization of all Provider Services databases and systems
Strong organizational skills.
Excellent written and verbal communication and interpersonal skills
Microcomputer Applications (Microsoft Word and Excel, Access Preferred) for use in all aspects of an office environment
Skilled data input
Skills in proactively engaging with providers and staff to determine root cause and address business issues (such as administrative, regulatory and customer service matters)
Training skills to educate providers and provider staff as needed, which may include counseling providers diplomatically, while retaining a positive working relationship
Skills in network development, by monitoring and enforcing company policies and procedures, while increasing Provider effectiveness by educating and promoting participation in various IEHP initiatives.
Benefits
Competitive salary
State of the art fitness center on-site
Medical Insurance with Dental and Vision
Life, short-term, and long-term disability options
Career advancement opportunities and professional development
Wellness programs that promote a healthy work-life balance
Flexible Spending Account – Health Care/Childcare
CalPERS retirement 457(b) option with a contribution match
Revenue Customer Success Manager driving retention, growth, and long - term value for customer accounts. Building relationships and aligning platform to customer business objectives.
Account Manager managing B2B sales cycle for BeNeLux region at an AI - focused SaaS startup. Collaborating with teams to enhance internal knowledge accessibility for SMEs.
Director of Client Partnerships at MedComms Experts focusing on account strategy and client direction. Driving revenue growth and team development in a hybrid work environment.
Account Manager managing daily client relationships and project coordination for We Are Social in Madrid. Overseeing teams and ensuring successful campaign execution.
Inside Territory Account Manager managing assigned territory for Fortinet's SLED team. Driving sales and building relationships with clients through effective account management.
SMB Account Manager responsible for nurturing healthcare practice relationships using SaaS. Driving product adoption and managing renewals while minimizing churn and ensuring account health.
Manage partner relationships to drive revenue for adjoe's mobile ad platform, utilizing analytical skills and growth strategies in a dynamic team environment.
Field Area Sales Account Manager responsible for retaining and growing B2B customers across Poole and wider Dorset for ADI Global Distribution, a leading wholesale distributor of electronic security and AV products.
Field Area Sales Account Manager responsible for managing B2B trade customers in Birmingham and the Midlands. Provide growth through relationship management and new customer acquisition in the electronic security sector.
Intern supporting the Brand Activation & Artist Partnerships team of Songtradr. Gaining understanding of music activations through research and client project support.