Managed Care Provider Relations Manager jobs in Saint Cloud, MN

The Opportunity

We are seeking a highly motivated Provider Relations Specialist responsible for field activities that provide education and support to providers in the Homeward service area. The Provider Relations Specialist will work with local providers to optimize quality and total cost of care performance based on health plan contractual arrangements.

What You’ll Do:

• An understanding of value-based care and risk-sharing methodology
• Experience impacting cross-functional clinical and operational teams through informal leadership
• Relationships within the Minnesota physician market and the ability to gain confidence and build partnerships within the same physician market
• Develop trusted relationships and maintain open lines of communication with providers through in-person visits, emails, phone
• Serve as primary contact for providers, serving as a liaison between the provider and Homeward
• Experience with clinical and physician outreach activities - particularly with rural community resources -  to develop programmatic partnerships and referral management
• Ability to gain access to decision-makers either by experience, reputation, or education
• Exceptional project management, communication, and leadership skills
• Willingness to travel daily within the rural counties of Minnesota for business development purposes
• Experience with healthcare strategy and a passion for re-architecting how health and care are delivered
• Conduct provider onboarding, orientation, and ongoing educational training throughout the year to optimize provider performance
• Conduct regular face-to-face meetings with the providers, documenting discussions, issues, attendees, and action items covering claims issues, quality care gaps, CAHPS, the use of HCCs, and member and provider rosters
• Collaborate with other departments to ensure provider inquiries are resolved in a timely and effective manner
• Create detailed reporting of provider visits, inquiries, trainings, and growth opportunities
• Collaborate with Homeward Navigators to ensure patients receive timely access to appropriate, high-quality care from assigned providers
• Problem-solve and identify ways to address provider issues timely and effectively
• Maintain and update provider rosters
• Investigate and communicate provider changes
• Work cross-functionally with internal departments
• The position requires the use of high-speed internet
• Must be able to travel frequently to the assigned service areas
• Other duties assigned by department leaders

What You Bring:

• Bachelor’s degree or equivalent years of experience preferred
• 2-3 years experience in provider network scope of services
• Strong understanding of Managed Care Operations
• Excellent written and verbal communication skills
• Proficient computer skills and Microsoft Office programs (i.e., Outlook, Excel, Word, and PowerPoint)
• Experienced in healthcare, provider engagement, Medicare, Medicaid, and Commercial managed care systems
• Relentlessly resourceful. You enjoy taking ownership and can get things done without excuses. You are resilient, detail-oriented, and truly believe that no task is beneath you
• Possess strong organizational skills, plan daily activities, and demonstrate initiative with minimal supervision to complete projects
• Comfortable with ambiguity and biased towards action. You enjoy thinking about complex and ambiguous problems and can execute consistently and add compounding value
• Comfortable working in a fast-paced environment
• Strong priority management, working independently, effectively managing time and resources
  
  

What Shapes Homeward:

• Deep commitment to one another, the people and communities we serve, and to provide care that enables everyone to achieve their best health
• Compassion and empathy
• Curiosity, and an eagerness to listen
• Drive to deliver high-quality experiences, clinical care, and cost-effectiveness
• Strong focus on sustainability of our business and scalability of our services, to maximize our reach and impact
• Nurturing a diverse workforce, with a wide range of backgrounds, experiences, and points of view
• Taking our mission and business seriously, but not taking ourselves too seriously– having fun as we build!

Benefits:

• Competitive salary and equity grant
• Unlimited PTO
• Comprehensive benefits package including medical, dental & vision insurance with 100% of monthly premium covered for employees
• Unlimited Paid Time Off
• Company-sponsored 401k plan
  
  

At Homeward, a diverse set of backgrounds and experiences enrich our teams and allow us to achieve above and beyond our goals. If you have yet to gain experience in the areas detailed above, we hope you will share your unique background with us in your application and how it can be additive to our teams.

Homeward is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. Homeward is committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities.