Administrative Operations Manager II / Provider Network & Relations (HCA/MAD #10117859)

$36.09 - $57.75 Hourly

$75,072 - $120,115 Annually

This position is a Pay Band 85

Posting Details

This job posting will be used to conduct ongoing recruitment and may close at any time. Applicant lists may be screened more than once.

This job posting may be used to fill multiple vacancies.

Our Vision

• Every New Mexican has access to affordable health care coverage through a coordinated and seamless health care system.

Our Mission

• We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.

Our Goals

• Leverage purchasing power and partnerships to create innovative policies and models of comprehensive health care coverage that improve the health and well-being of New Mexicans and the workforce.
• Achieve health equity by addressing poverty, discrimination, and lack of resources, building a New Mexico where everyone thrives.
• Implement innovative technology and data-driven decision-making to provide unparalleled, convenient access to services and information.
• Build the best team in state government by supporting employees' continuous growth and wellness.

Why does the job exist?

The AO II Provider & Network Relations Manager will:

• Typically work 75% with Provider Relations;
• Provide training opportunities to new provider types in classes and on-site formats;
• Field individual questions from new providers attempting to onboard;
• Manage the entire experience of the providers from obtaining a business license, obtaining an NPI, Medicaid enrollment and MCO credentialing & contracting and successfully billing Medicaid;
• Meet regularly with professional organizations on provider issues with enrollment and billing;
• Coordinate between providers and MCO's on the efficacy of the new single credentialing platform.

How does it get done?

The AO II Provider & Network Relations Manager is responsible for:

• Supervising the positions responsible for provider contract and reporting submissions and any administrative/other staff related duties;
• Establishing and maintaining effective working relationships between providers, MCO's, and internal/external stakeholders;
• Evaluating and planning short and long-term goals, as well as determining strategies to successfully meet expected outcomes;
• Determining resources required to meet program objectives requiring anticipation of and possible resolutions to barriers, setbacks, and challenges;
• Directing and guiding staff to meet the intended goals of the program;
• Other duties as assigned to support the New Mexico Medicaid provider enrollment process.

Who are the customers?

• Internal and External Stakeholders throughout The Health Care Authority (HCA);
• MCOs and Medicaid Providers;
• The HCA Office Of The Secretary (OOS).

Ideal Candidate

The Ideal Candidate has:

• Experience with customer service in healthcare or insurance industry;
• Experience with healthcare administration;
• Experience with Medicaid and / or health care programs;
• Experience working with multiple stakeholders;
• The ability to prioritize and handle critical projects simultaneously;
• Experience managing and supervising personnel;
• Familiarity with insurance policies, claims processing, and provider contracts;
• Strong communication skills, both written and verbal.

Minimum Qualification

A Bachelor's degree in any field of study from an accredited college or university and eight (8) years of professional level experience with a light strategic impact directly related to the purpose of the position defined by the agency at the time of recruitment. Any combination of education from an accredited college or university and/or direct experience in this occupation totaling twelve (12) years may substitute for the required education and experience. A hiring agency will designate a portion of the required experience to include management, supervisory and/or specialized experience. Any required licensure, certification or registration shall be defined at the time of recruitment and will be in addition to the above requirements.

Employment Requirements

Must possess and maintain valid driver's license.

Working Conditions

Work is performed in an office setting with exposure to Visual/Video Display Terminal (VDT) and extensive personal computer and phone usage. Some sitting, standing, bending and reaching may be required. Must be able to lift 25lbs. Instate travel will be required.

Supplemental Information

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Agency Contact Information: Jolene Jaffa, (505) 690-9920. Email

For information on Statutory Requirements for this position, click the Classification Description link on the job advertisement.

Bargaining Unit Position

This position is not covered by a collective bargaining agreement.