Manager, Provider Network
Apply NowCompany: InnovAge
Location: Richmond, VA 23223
Description:
Responsibilities
This position is Remote but geographic preference is Pennsylvania or Virginia. The selected applicant will be responsible for contracting and servicing providers in Pennsylvania, Virginia and Florida.
Under the direction of the SVP Provider Strategy and Network Management, this role manages the development and sustainability of the affiliate provider network. Responsible for sourcing and the introduction of InnovAge PACE to the provider community. Works in collaboration with primary care and operations leadership to identify and contract with community affiliate providers to meet the complex needs of the InnovAge PACE participants. This position will collaborate with the InnovAge legal team to coordinate contracting and credentialing activities. The Manager, Provider Network is responsible for contracting, provider education, and provider relations support of the mid-size group and individual providers utilizing boilerplate contracts and standard payment methodology as defined by the SVP of Provider Strategy and Network Management. The Manager, Provider Network provides provider and operational support to ensure compliance with contracted terms, access, and availability.
Essential Functions and Work Responsibilities
Functional Category: Provider Network Management
Estimated Percent of time Spent - 100%
Responsible for identifying provider targets initiating/finalizing provider contracts through the InnovAge contracting process.
Build and develop strong face to face and virtual relationships within the provider community to ensure that effective partnerships are in place to meet the needs of the organization and its participants.
Works in collaboration with the Primary Care Team and the Interdisciplinary Team to identify gaps in the provider network.
Responsible for conducting provider in-services and educating network providers on the InnovAge PACE model of care and processes.
Responsible for utilizing InnovAge PACE approved materials that are in compliance with state, CMS and any other regulatory agency.
Responsible for communicating and updating providers on any changes in practice or process in collaboration with the Interdisciplinary Team and the department SVP.
Conducts face to face provider service visits.
Provide the department SVP with their strategy approach to close access to care gaps through analysis of the provider network's effectiveness and accessibility.
Under the direction of the SVP Provider Strategy and Network Management assist in addressing provider related issues including but not limited to provider and participant grievance and appeals, claims, communication barriers and any other related provider relation concerns in a timely and a professional manner.
Travel Requirements
Travel
Travel required
Overnight travel out of state
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
REQUIRED
Education
Bachelor's degree from an accredited college or university in an appropriate discipline, e.g., Business, Healthcare Administration, Public Health
Work Experience and Qualifications
A minimum of 3 years' experience with network development and management.
Managed care contracting and provider relations experience is required.
Experience with provider network processes and account management is essential.
Previous experience with Medicare and Medicaid is preferred
The pay offered for the position will take into consideration the candidate's geographic region, job-related knowledge, skills, experience, and internal equity, among other factors. InnovAge offers a comprehensive benefit package which includes medical, dental and vision insurance, short and long-term disability, life insurance and add, supplemental life insurance, flexible spending accounts, 401(k) savings, paid time off, and company paid holidays.
Benefits
InnovAge is dedicated to empowering seniors to live independently, allowing them to age in their own homes and communities safely. InnovAge offers an alternative to nursing homes through its Program of All-inclusive Care for the Elderly (PACE), which provides enrolled seniors with customized healthcare and social support at PACE Adult Day Health Centers. These centers are staffed by medical professionals who are committed to creating personalized care plans for each participant. At InnovAge, our team members are our greatest asset and have a significant impact on the lives of our participants every day. When you join InnovAge, you'll work alongside talented, respectful, and passionate colleagues within a patient-centered care model.
InnovAge is committed to equal opportunity and affirmative action, and we strive to create a diverse and inclusive workplace. We consider all qualified candidates for employment without discrimination based on race, color, religion, sex, sexual orientation, gender identity/expression, national origin, disability, protected veteran status, pregnancy, or any other protected status. Salaries are determined by various factors such as qualifications, experience, and location, and do not include potential bonuses or benefits. Our extensive benefits package includes medical/dental/vision insurance, short and long-term disability, life insurance and AD&D, supplemental life insurance, flexible spending accounts, 401(k) savings, paid time off, and company-paid holidays.
Applicants are considered until the position is filled.
Posted Salary Range
USD $96,150.00 - USD $125,000.00 /Yr.
This position is Remote but geographic preference is Pennsylvania or Virginia. The selected applicant will be responsible for contracting and servicing providers in Pennsylvania, Virginia and Florida.
Under the direction of the SVP Provider Strategy and Network Management, this role manages the development and sustainability of the affiliate provider network. Responsible for sourcing and the introduction of InnovAge PACE to the provider community. Works in collaboration with primary care and operations leadership to identify and contract with community affiliate providers to meet the complex needs of the InnovAge PACE participants. This position will collaborate with the InnovAge legal team to coordinate contracting and credentialing activities. The Manager, Provider Network is responsible for contracting, provider education, and provider relations support of the mid-size group and individual providers utilizing boilerplate contracts and standard payment methodology as defined by the SVP of Provider Strategy and Network Management. The Manager, Provider Network provides provider and operational support to ensure compliance with contracted terms, access, and availability.
Essential Functions and Work Responsibilities
Functional Category: Provider Network Management
Estimated Percent of time Spent - 100%
Responsible for identifying provider targets initiating/finalizing provider contracts through the InnovAge contracting process.
Build and develop strong face to face and virtual relationships within the provider community to ensure that effective partnerships are in place to meet the needs of the organization and its participants.
Works in collaboration with the Primary Care Team and the Interdisciplinary Team to identify gaps in the provider network.
Responsible for conducting provider in-services and educating network providers on the InnovAge PACE model of care and processes.
Responsible for utilizing InnovAge PACE approved materials that are in compliance with state, CMS and any other regulatory agency.
Responsible for communicating and updating providers on any changes in practice or process in collaboration with the Interdisciplinary Team and the department SVP.
Conducts face to face provider service visits.
Provide the department SVP with their strategy approach to close access to care gaps through analysis of the provider network's effectiveness and accessibility.
Under the direction of the SVP Provider Strategy and Network Management assist in addressing provider related issues including but not limited to provider and participant grievance and appeals, claims, communication barriers and any other related provider relation concerns in a timely and a professional manner.
Travel Requirements
Travel
Travel required
Overnight travel out of state
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
REQUIRED
Education
Bachelor's degree from an accredited college or university in an appropriate discipline, e.g., Business, Healthcare Administration, Public Health
Work Experience and Qualifications
A minimum of 3 years' experience with network development and management.
Managed care contracting and provider relations experience is required.
Experience with provider network processes and account management is essential.
Previous experience with Medicare and Medicaid is preferred
The pay offered for the position will take into consideration the candidate's geographic region, job-related knowledge, skills, experience, and internal equity, among other factors. InnovAge offers a comprehensive benefit package which includes medical, dental and vision insurance, short and long-term disability, life insurance and add, supplemental life insurance, flexible spending accounts, 401(k) savings, paid time off, and company paid holidays.
Benefits
InnovAge is dedicated to empowering seniors to live independently, allowing them to age in their own homes and communities safely. InnovAge offers an alternative to nursing homes through its Program of All-inclusive Care for the Elderly (PACE), which provides enrolled seniors with customized healthcare and social support at PACE Adult Day Health Centers. These centers are staffed by medical professionals who are committed to creating personalized care plans for each participant. At InnovAge, our team members are our greatest asset and have a significant impact on the lives of our participants every day. When you join InnovAge, you'll work alongside talented, respectful, and passionate colleagues within a patient-centered care model.
InnovAge is committed to equal opportunity and affirmative action, and we strive to create a diverse and inclusive workplace. We consider all qualified candidates for employment without discrimination based on race, color, religion, sex, sexual orientation, gender identity/expression, national origin, disability, protected veteran status, pregnancy, or any other protected status. Salaries are determined by various factors such as qualifications, experience, and location, and do not include potential bonuses or benefits. Our extensive benefits package includes medical/dental/vision insurance, short and long-term disability, life insurance and AD&D, supplemental life insurance, flexible spending accounts, 401(k) savings, paid time off, and company-paid holidays.
Applicants are considered until the position is filled.
Posted Salary Range
USD $96,150.00 - USD $125,000.00 /Yr.