PRM II- Colorado in Colorado Springs, CO at Beacon Health Options

Date Posted: 10/21/2018

Job Snapshot

Job Description

ABOUT THE POSITION

We are currently seeking a dynamic Provider Relations Manager II (Lead) to join our team at our office in Colorado Springs, Colorado.  The Provider Relations Manager II (Lead) will be primarily responsible for recruitment, contracting and credentialing, provider education and outreach as well as on-going quality monitoring. 

Position Responsibilities:

  • Recruits new practitioners (i.e., individual, group) and hospital based practitioners to join the provider network.  Identifies potential practitioners through independent research, network inclusion requests or attendance at professional gatherings.  Performs preliminary screening and office visits as required by required by contract or other performance standard.
  • Assists to nominate providers interested in joining the network.

  • Facilitates provider understanding of contract terms and provider requirements.

  • Performs provider and facility outreach to manage the ongoing relationship and is the critical interface link with regional and corporate provider relations and network operations staff in the seamless delivery of services to providers.  

  • Assists in the development and implementation of policies and procedures, internal workflows and other tools for staff training and compliance.  

  • Coordinates all aspects of provider trainings to meet network needs and/or state requirements. Trainings may be conducted in various in-person, web-based and pre-recorded training platforms to small and large audiences. Collaborates with other internal departments (e.g. clinical, claims, quality) to identify, develop and deliver the accurate training content

Position Requirements:

Education: Bachelor Degree in relevant discipline (e.g., business, marketing, communications, health sciences, behavioral health, social work, public health, etc.) or equivalent experience commensurate with job responsibilities+

Licensure:  N/A

Travel: Ability to travel local and distant provider offices in assigned region by various means.

Relevant Work Experience:   At least five years of experience in provider relations, preferably with a managed health care organization or government/regulatory entity. A  Managed care background (e.g. HMO, Insurance Company, Medicaid MCO or Medicare Advantage Plan) in provider relations, contracting and/or provider network development is highly desirable.  Knowledge of primary care and medical home standards will take precedence. Must possess three-years supervisory experience for those positions requiring management of subordinate staff. 

Knowledge, Skills & Abilities:

  • Individual must be a self-starter, with strong organizational skills
  • Must be able to communicate effectively with peers as well as members of the national executive and senior leadership team. 
  • Individual must possess poise to manage multiple competing priorities across the Corporate matrix leadership team in accordance with set deliverable timeframes.

TO APPLY

Click below on “Apply for this Position” to create a profile and apply for the position

Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment.EOE/AA/M/F/Veterans/Disabled

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