Mgr, Prov Network Relations (Finance)

We offer remote work opportunities (AK, AR, AZ, CA, *CO, FL, *HI, IA, ID, *IL, KS, LA, MD, *MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, *WA, WI & WY only).

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Veterans, Reservists, Guardsmen and military family members are encouraged to apply!

Job Summary

In partnership with the Director, Provider Network Relations, is responsible for supporting customer satisfaction for all stakeholders of TriWest's provider network to include: identifying strategies to resolve network subcontractor operational issues; oversee all staff recruiting, staff new hire orientation and ongoing training; managing and allocating resources and staff to support provider relations and education requirements, VA Medical Center (VAMC) education, and network subcontractor training; and participating in quality improvement projects throughout the organization. The Manager oversees and is responsible for activities related to provider relations and education and contract compliance and other assigned responsibilities; including, but not limited to, the achievement, motivation, and training of subordinate staff located at remote (out of state) sites and at the Corporate office. This position is also responsible for all aspects of tracking and reporting activities of all network subcontractors fulfillment of their specific statement of work.

Education & Experience

Required:

• Bachelor's (BS/BA) Degree and six (6) years of varied and responsible experience with health care programs, or any combination of education and experience that provides an equivalent background
• If supporting TRICARE contract, must be a U.S. Citizen
• If supporting TRICARE contract, must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation
• Minimum of three (3) years supervisory/management experience

Preferred:

• Three (3) years' experience in provider relations, provider contracting, or healthcare operations

Key Responsibilities

• Assist Director with managing department budget, goals, and staff to promote high levels of customer satisfaction and efficiency, and streamline processes.
• Oversight of critical departmental projects and produce cross-departmental positive outcomes and results.
• Demonstrate and maintain current knowledge of all VA programs, contracting, credentialing, reimbursement and operational policies and participate in all required training. Maintain current knowledge of TriWest initiatives, operations, and goals.
• Collaborate closely with other department leadership, staff, and leadership/staff in other TriWest departments on process improvement and service level improvements.
• Direct staff to resolve complaints and grievances tied to the provider network. Oversee coordination of processes, staff and reporting to support contractual response times. Engage in escalated media or congressional issues as needed.

• Train employees in job responsibilities, including all aspects of conducting network subcontractor weekly meetings, resolving provider issues in collaboration with Claims and Operations departments, and reporting feedback to VA. Provide initial and ongoing training, observe presentations/meetings and provide feedback, monitor evaluation scores and comments for improvement opportunities.
• Manage hourly and professional staff based in Phoenix and remotely. Monitor productivity, quality and quantity of work performed by staff. Engage in regular staff development activities to include meetings with each staff person at least monthly, training with each new field staff member in their territory, and ongoing training as needed. Develop and conduct staff training conferences in Phoenix, at least annually. Provide mentoring, recognition and coaching, and work collaboratively with staff to establish goals. Develop appropriate performance improvement plans, if needed.
• Plan and organize network subcontractor conferences (as needed) and/or lead operations workgroups. Includes agenda management and scheduling speakers; may also be in charge of coordinating logistics (if in person vs. remote).
• Manage all staff that support network subcontractors on a weekly basis, and function as escalation point for network-wide priorities and issues. Work with senior management to cascade network objectives and changes down to subcontractors, and summarize systemic trends/needs from subcontractors up to leadership as needed.
• Act as key administrator of network subcontractor portal and implement monthly reporting to all network subcontractors, with support from Data Management. Coordinate with Finance department on necessary reporting tied to subcontractor payments.
• Head or participate in various projects and committees assigned by Director, as well as other duties as assigned.

Competencies

Coaching / Training / Mentoring: Actively foster actions required for desired business outcomes through ongoing constructive feedback.

Commitment to Task: Ability to conform to established policies and procedures; exhibit high motivation.

Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapt to different styles; listen critically; collaborate.

Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.

Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required.

Creativity / Innovation: Ability to develop unique and novel solutions to problems; view change as necessary.

Delegation Skills: Provide clear performance expectations for projects and ensure adequate access to resources for completion.

Information Management: Ability to manage large amounts of complex information easily, communicate clearly, and draw sound conclusions.

High Intensity Environment: Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow.

Leadership: Successfully manage different styles of employees; provide clear direction and effective coaching.

Multi-Tasking / Time Management: Prioritize and manage actions to meet changing deadlines and requirements within a high volume, high stress environment.

Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.

Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues.

Team-Building / Team Player: Influence the actions and opinions of others in a positive direction and build group commitment.

Working Conditions

Working Conditions:

• Favorable working conditions in a climate-controlled office space
• Must be able to travel (locally or distant with overnight stays) a minimum of ten (10) percent and maximum of thirty-five (35) percent of the time
• Must be able to lift a minimum of 20 lbs
• Must be able to work under stressful conditions
• Must be available to cover any work shift

Company Overview

Taking Care of Our Nation's Heroes.

It's Who We Are. It's What We Do.

Do you have a passion for serving those who served?

Join the TriWest Healthcare Alliance Team! We're On a Mission to Serve®!

Our job is to make sure that America's heroes get connected to health care in the community.

At TriWest Healthcare Alliance, we've proudly been on that important mission since 1996.

Benefits

We're more than just a health care company. We're passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:

• Medical, Dental and Vision Coverage
• Generous paid time off
• 401(k) Retirement Savings Plan (with matching)
• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
• Tuition reimbursement
• Paid volunteer time

*Annual base salary for Colorado, Hawaii, Illinois, Minnesota, Washington D.C. and Washington State residents: $88,000 - $113,000 depending on experience*

Equal Employment Opportunity

TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that cultivates and supports diversity at every organizational level, including hiring and retaining a diverse workforce, and we highly encourages candidates from all backgrounds to apply. Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.