Supervisor-Provider Network Management

Presbyterian is seeking a Supervisor-Provider Network Management

Supervises network strategies and relationship development activities for assigned providers including individualized planning, training and development of providers to align with Presbyterian s clinical quality initiatives. Ensures that productivity and quality standards are being maintained. Provides leadership and assistance to the Provider Network Management staff through supervision and coordination of the daily operations. Major duties include coordination of team resource assignments, mentoring of team members, and acting as point of contact/liaison for all team deliverables and accountabilities. Provides leadership and assistance to servicing team through supervision and coordination of daily operations. Major duties include supervising day to day serving operations, including coordination of team resource assignments, mentoring of the team members and acting as point of contact/liaison for all team deliverable and accountabilities.

 

• This is a Full Time position - Exempt: Yes
• Job is based at Rev Hugh Cooper Admin Center
• Work hours: Weekday Schedule Monday-Friday

• Bachelors degree preferred; at least 5 years experience in managed care or health care preferred. Or 6 years relevant managed care/health care experience. Requires effective coaching, counseling, and conflict management skills.
• Must be able to work collaboratively with other employees and the ability to multi-task.
• Demonstrated ability to sustain quality standards. Demonstrated ability to communicate in verbal and written form with peers, subordinates and the public, including physicians, physician office staff and staff.
• Ability to handle fluctuating workloads, conflicting priorities, and concurrent activities.
• Ability to influence many parties internally and externally, both inside and outside of formal reporting relationships.
• Ability to synthesize, process, and authoritatively/persuasively communicate complex concepts.
• Work team and matrixed project team leadership skills, including the ability to organize and manage multiple priorities under aggressive deadlines.
• Technical Skills- Experience in PC fundamentals proficient with MS-Windows, MS Excel, MS Word, Visio, MS Project, MS Access and MS PowerPoint

• Supervises and provides day to day support to provider network servicing team.
• Collaborates and maintains relationships with providers and staff throughout Presbyterian to ensure an exceptional provider experience.
• Develops and maintains cooperative working relationships between PHP, institutional provider and individual providers.ie NST s and site visits.
• Provides education on quality initiatives, managed care, capitation, products, policies and procedures, reimbursement issues, referral/authorization process, etc.
• Oversees quality of team deliverables and assist with deliverables where required. ie provider email boxes, provider term/member move, provider directory validation, PIF verification and validation.
• Oversees provider directory proofing and provider data validation process related to the production of the provider directory.
• Formulates work plans and assignments based on the analysis of the inventory workload, available personnel, and priorities.
• Ensures team members perform tasks in accordance with established department and organization policies and standards.
• Ensures team is focused on appropriate goals and removes barriers to success.
• Acts as a point of contact, liaison and escalation for all team solution delivery matters.
• Ensures that performance standards are being maintained by performing ongoing monitoring and audits of processes and workflows.
• Provides counsel and feedback to team members regarding audit and performance results
• Participates in recruitment and retention of staff, coordinates training with the Network Instructional Designer for new and existing team members.
• Effectively works with peers, team members, and other key stakeholders leading or participating in process improvement; acting as a catalyst for change.

We offer more than the standard benefits!

Presbyterian employees gain access to a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more!

Learn more about our employee benefits:

https://www.phs.org/careers/why-work-with-us/benefits

Why work at Presbyterian?

As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans. For our employees, we offer a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more.

Presbyterian's story is really the story of the remarkable people who choose to work here. The hard work of our physicians, nurses, employees, board members and volunteers grew Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system that serves more than 875,000 New Mexicans.

About Presbyterian Healthcare Services

Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1,600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

About Our Regional Delivery System

Presbyterian's Regional Delivery System is a network of six hospitals and medical centers throughout rural New Mexico including locations in Clovis, Espanola, Ruidoso, Santa Fe, Socorro and Tucumcari. Our regional facilities are home to more than 1,600 clinical and non-clinical employees who help make Presbyterian the state's largest private employer with nearly 14,000 statewide employees. With a variety of services ranging from general surgery to pediatrics to heart and cancer care, our regional employees are proud to provide close-to-home care for their communities.

We are part of New Mexico's history - and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come.

About New Mexico

New Mexico continues to grow steadily in population and features a low cost-of living.

Varied landscapes bring filmmakers here from around the world to capture a slice of the natural beauty New Mexicans enjoy every day. Our landscapes are as diverse as our culture - from mountains, forests, canyons, and lakes, to caverns, hot springs and sand dunes.

New Mexico offers endless recreational opportunities to explore and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

USD $42.63/Hr.

The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.