Provider & Vendor Operations Manager

Network Health's success is rooted in its mission to create healthy and strong Wisconsin communities. Network Health is seeking a Provider & Vendor Operations Manager. This position is responsible for the overall operational relationship with providers and/or supplemental vendors. Participates in provider satisfaction efforts with Network Health through development of internal and external stakeholder relationships, provider education, supplemental vendor management, problem resolution, and collaboration with internal Network Health departments.

This position will build strong relationships with provider and/or supplemental vendors, overall market knowledge, participation in Provider Satisfaction Team, developing consistent feedback methods with providers and/or supplemental vendors through face to face meetings and proxy surveys, Practice Manager meetings and other communications with providers and/or supplemental vendors.

Location:

Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required), at our office in Brookfield or Menasha, or a combination of both in our hybrid workplace model.

Hours:

1.0 FTE, 40 hours per week, 8am-5pm Monday through Friday

Check out our 2024 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.

Job Responsibilities:

• Manages provider and/or supplemental vendor operations concerns and issues
• Ability to craft solutions through understanding of provider and/or supplemental vendor needs and leveraging of company resources
• Exceptional listening and communication skills
• Collaborates well with other internal departments
• Ability to build and maintain effective working relationships
• Strong organizational skills
• Establishes effective and efficient relationships with contracted providers and/or supplemental vendors as needed to achieve the corporate strategies and goals of health
• Maintains a high profile among key providers and/or supplemental vendors through regular contact and support using various effective and efficient forms of communication and account management techniques.
• Provides collaborative and matrix support to NH operations and participating providers and/or supplemental vendors, resolving problems and providing information pertaining to programs, protocols, policies and procedures
• Provides new provider orientation
• Develops provider payment policies
• Coordinates and participates in biannual practice manager meetings and specialty meetings
• Creates articles for monthly provider newsletter and other provider marketing material
• Ability to speak fluently to payment policies, programs, portal, provider page, operations
• Conducts proxy provider satisfaction surveys
• Contracts with providers and/or supplemental vendors on an as needed basis

Job Requirements:

• Bachelors degree in a related field is preferred or eight years of equivalent experience may be subsituted.
• Minimum of four years of experience in the health care industry (hospital, health insurance, or physician practice). Minimum of two years health services negotiation and provider/customer service experience, preferably health insurance and/or provider.
• Valid drivers license.
• Working knowledge of medical terminology, health care billing/coding, reimbursement and insurance benefit methodologies.
• Exceptional customer service/relationship management skills.
• Advanced health care financial, reimbursement and utilization data and analysis skills
• Microsoft Office
• QNXT
• Medicare knowledge.

We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce.