In partnership with the Director, Provider Relations & Education, is responsible for identifying provider education requirements and identifying strategies to provide the necessary provider education; staff recruiting, staff new hire orientation and ongoing training; managing and allocating resources and staff to support civilian provider relations and education requirements, VA Medical Center (VAMC) education, and network subcontractor training; manages development and distribution of provider communications and educational materials, including website content on TriWest.com/Provider and the network subcontractor portal.
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 scheduling, conducting, and support of provider webinars and seminars.
o Assist Director with managing department budget, goals, and staff to promote high levels of customer satisfaction and efficiency, and streamline processes.o Manager contract negotiations for key hospital systems and network providres that require complex analysis and coordination between contracting, credentialing, data and claims.
o Oversight of critical departmental projects and produce cross-departmental positive outcomes and results.
o 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.
o Collaborate closely with other department leadership, staff, and leadership/staff in other TriWest departments on process improvement and service level improvements.
o Manage development of content and review of provider communications and materials for civilian and military providers, including provider webinars, seminars, and eSeminars; provider eNewsletter and QuickAlert publications; provider handbook, quick reference guides and other materials.
o Manage the provider outreach program, including TriWest-hosted events. Manages expansion of electronic provider education and communications offerings and oversight of the provider email address campaign.
o Manage the Provider Portal, working with IT to enhance and repair functionality.o
Manage webinar content loaded into Provider Portal/Adobe Connect, including scheduling of host and assistant presenters for live provider webinars. Proficient with Adobe Connect and Provider Portal; covers any role in conducting webinars in the event of unforeseen circumstances.
o Manage the eSeminar functionality and content in Provider Portal, working with IT and to resolve any issues.
o Oversee reporting from Provider Portal, including development and/or distribution of recurring reports. Develop and maintain monthly reports to identify and monitor staff activities.
o Oversee the research, identification, and negotiation of contracts with facilities to conduct live provider seminars, including use of premises, food and beverage, equipment, materials distribution and logistics, and planning and scheduling seminars throughout the Region.
o Train employees in job responsibilities, including all aspects of conducting live seminars and webinars, including use of Adobe Connect, Provider Portal, presentation skills and conducting VA briefings. Provide initial and ongoing training, observe presentations and provide feedback, monitor evaluation scores and comments for improvement opportunities.
o Manage clerical 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.
o Plan and organize network subcontractor conferences. Includes agenda management and scheduling speakers, coordinating receipt of speaker presentations, contracting with the facility, including food and beverage; planning two evening events.
o Head or participate in various projects and committees assigned by Director, as well as other duties as assigned.
Education & Experience
o 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.
o Minimum of three (3) years supervisory/management experience.
o Three (3) years experience in provider relations, provider contracting, or healthcare claims/billing
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