Regional Provider Network Manager

The range for this role is $70,000 - $95,000
Actual base pay will be determined based on a successful candidate's work location, skills/abilities, experience, and education. This role includes opportunity to receive an annual bonus target of 10% of annual eligible earnings. Actual bonus amounts are determined by length of time in role, individual performance, and organizational performance.
Candidates for this role will be covering the West Coast (AZ, NV, CA, WA, OR) and_ would need to have established residency in Arizona._* Frequent travel to visit medical providers within this region will be required.*

The Mission
At Christian Care Ministry we believe that Christians can, and should, share in one another's burdens. Through the use of Medi-Share®, a healthcare sharing ministry for Christians, we cultivate that belief.
The Team
Everyone at Christian Care Ministry is in agreement with our Statement of Faith, which outlines our core beliefs. Although we aren't perfect people, we are serving our perfect God to the best of our ability.
The Job
The Provider Network Manager is responsible for gathering and analyzing provider data and feedback, addressing any issues or concerns, and resolving them in a timely and efficient manner to ensure that provider satisfaction and access to the provider for our members remains in place. The Provider Network Manager will create long-term relationships with providers and engage with them regularly to ensure that they are appropriately informed and updated on Christian Care Ministry's products, service offerings, and the latest member-voted guideline updates.

Essential Job Duties & Responsibilities

• Initiate and maintain effective channels of communication with service providers and clients
• Gather, review, and verify relevant information relating to participating providers
• Establish and maintain relationships with assigned providers through office visits, telephone calls, prompt resolution of issues, and excellent customer service
• Conduct training for service providers on member-voted guidelines and new product offerings
• Respond to questions from doctors' offices on any issues they are experiencing
• Gather, review, and submit relevant documentation needed for bill processing
• Maintain a working knowledge of all applicable federal, state, and local laws and regulations regarding healthcare
• Assist call center staff with more complicated member eligibility queries received
• Identify shortfalls in healthcare provision and initiate improvement opportunities
• Facilitate direct contracts with critical providers and provider groups
• Monitor, mitigate, and report member and provider abrasion related to cost containment vendors
• Perform and/or administer research in ensuring effective, timely responsiveness to all provider issues through an established escalation process
• Coordinate Provider Contract administration
• Ensure updates and adherence to operational and administrative policies and procedures
• Assist in developmental projects / policies / procedures and other related issues
• Contribute to the exercise and expression of Christian Care Ministry's Christian beliefs
• All other duties as assigned

Essential Skills & Abilities

• Advanced understanding of Christian Care Ministry Guidelines
• Ability to effectively communicate and document all communication with internal and external customers in approved, auditable, and secure platforms and systems
• Excellent oral and written communication skills
• Interpersonal and intercultural competencies
• Ability to read, interpret, and apply vendor and provider contracts
• Ability to write routine reports and correspondence; and speak effectively with members, providers, and/or associates of the organization
• Proficiency with Microsoft Office (Excel, Word, Outlook)

Core Competencies/Demonstrable Behaviors

• Collaborates – builds partnerships and works collaboratively with others to meet objectives. This role requires a high level of internal customer interaction to meet objectives
• Manages Conflict – handles conflict situations effectively
• Interpersonal Savvy – relates openly and comfortably with a diverse group of people. Must be able to communicate effectively and build engagement across all audiences
• Drives Results – consistently achieves results, even under tough circumstances and tight deadlines
• Situational Adaptability – adapting approach and demeanor in real time to match the shifting demands of different situations
• Courage – ability to have tough conversations and deliver accurate advice and decisions regardless of risk or potential criticism

Education and/or Experience

• 3-5 years' experience with health plans, healthcare networks/PPOs, medical billing, provider relations, medical coding OR combination of education and experience required
• Bachelor's degree in a Healthcare or business related field is preferred
• Proficiency in creating presentations, training documents, reports, and analytical graphs preferred
• Agile, Lean, or other process improvement certification is preferred
• Sales representative experience strongly preferred

Supervisory Responsibilities

• This job has no supervisory responsibilities

Travel

• Willing and able to travel up to 25% of the time to visit in person with medical providers

Incentives & Benefits
We work hard to serve our Medi-Share Members, but know we can only do that if we invest in our employees professionally, financially, physically, socially, and spiritually. We purposefully invest in our employees so that our employees can invest in others.
For full-time employees working 30 hours or more, some of our benefits include, but are not limited to:

• Medical
• Health Savings Account
• Employer Paid Life Insurance and Long-term Disability Insurance
• Dental
• Vision
• Short-term Disability
• Accident, Critical Illness, Hospital Indemnity
• 401(k) – up to 4% match
• Paid-time off – accrued bi-weekly
• Wellness plan
• Employee Assistance Program
• Anniversary Awards Program
• Birthday Awards

Job Type: Full-time

Pay: $70,000.00 - $95,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Parental leave
• Professional development assistance
• Referral program
• Retirement plan
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Work Location: Remote