Senior Provider Relations Manager
IEHP, Rancho Cucamonga, CA, United States
What you can expect!
Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!
Responsibilities
Independently lead efforts to develop and maintain strong and consistent relationships with IEHP Providers, including IEHP-Direct Providers and independent practice organizations such as Primary Care Locations, Independent Practice Associations, OB/GYNs, Urgent Care Centers, and others as assigned.
Guide Team Members within Provider Relations and other IEHP stakeholder departments in network development, network adequacy, and provider training and education efforts in alignment with IEHP’s overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations.
Under general supervision of the Provider Relations Managers, mitigate provider issues and help project implementation to improve the quality of care provided to IEHP Members.
Serve as a Subject Matter Expert for external department workgroups and activities that involve Provider Relations and serve as a model of leadership for the team.
Education & Experience
Two (2) years of experience in an IEHP Provider Relations Manager role.
Proven successful meeting of monthly required in-services with a variety of specialty providers; exceeds major Provider Relations Manager functions and goals set by department leadership in the latest annual review.
Bachelor’s degree from an accredited institution required.
Key Qualifications
Proficient in MediTrac (HSP), NDDB, DataOps, creating standard work and job aids, Microsoft Excel.
Exceptional leadership, problem‑solving and critical‑thinking skills.
Strong presentation and written communication skills.
Ability to present new training material to a group of team members; skilled at maintaining strong collaborative relationships across multiple departments and IPAs.
Advanced knowledge of medical group, IPA, and HMO operations.
Strong attention to detail; ability to work independently, under pressure and meet deadlines.
Ability to gather and analyze data in a detailed and highly organized manner.
Ability to establish and maintain effective working relationships, trustworthy, reliable and an independent worker.
The Senior PRM should demonstrate a strong sense of ownership of IEHP’s relationship with the provider that recognizes the provider as a valuable partner. This quality is supported by the following:
Ability to proactively engage with high‑visibility providers, their staffs (including senior leaders and physicians) and PRMs to determine root cause and address business issues such as administrative, regulatory and customer service matters.
Ability to assume a leadership role in increasing provider effectiveness by educating and promoting provider participation in various IEHP initiatives, including administrative cost effectiveness, member satisfaction (CAHPS), regulatory‑related, IEHP quality programs, and electronic solutions (EDI, EFT, EMR, provider portal, provider website, etc.).
Benefits
CalPERS retirement
457(b) option with a contribution match
Generous paid time off – vacation, holidays, sick
State‑of‑the‑art fitness center on‑site
Medical insurance with dental and vision
Paid life insurance for employees with additional options
Short‑term and long‑term disability options
Pet‑care insurance
Flexible spending account – health care/childcare
Wellness programs that promote a healthy work‑life balance
Career advancement opportunities and professional development
Competitive salary with annual merit increase
Team bonus opportunities
Pay Range
$80,059.20 USD annually – $106,059.20 USD annually
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Responsibilities
Independently lead efforts to develop and maintain strong and consistent relationships with IEHP Providers, including IEHP-Direct Providers and independent practice organizations such as Primary Care Locations, Independent Practice Associations, OB/GYNs, Urgent Care Centers, and others as assigned.
Guide Team Members within Provider Relations and other IEHP stakeholder departments in network development, network adequacy, and provider training and education efforts in alignment with IEHP’s overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations.
Under general supervision of the Provider Relations Managers, mitigate provider issues and help project implementation to improve the quality of care provided to IEHP Members.
Serve as a Subject Matter Expert for external department workgroups and activities that involve Provider Relations and serve as a model of leadership for the team.
Education & Experience
Two (2) years of experience in an IEHP Provider Relations Manager role.
Proven successful meeting of monthly required in-services with a variety of specialty providers; exceeds major Provider Relations Manager functions and goals set by department leadership in the latest annual review.
Bachelor’s degree from an accredited institution required.
Key Qualifications
Proficient in MediTrac (HSP), NDDB, DataOps, creating standard work and job aids, Microsoft Excel.
Exceptional leadership, problem‑solving and critical‑thinking skills.
Strong presentation and written communication skills.
Ability to present new training material to a group of team members; skilled at maintaining strong collaborative relationships across multiple departments and IPAs.
Advanced knowledge of medical group, IPA, and HMO operations.
Strong attention to detail; ability to work independently, under pressure and meet deadlines.
Ability to gather and analyze data in a detailed and highly organized manner.
Ability to establish and maintain effective working relationships, trustworthy, reliable and an independent worker.
The Senior PRM should demonstrate a strong sense of ownership of IEHP’s relationship with the provider that recognizes the provider as a valuable partner. This quality is supported by the following:
Ability to proactively engage with high‑visibility providers, their staffs (including senior leaders and physicians) and PRMs to determine root cause and address business issues such as administrative, regulatory and customer service matters.
Ability to assume a leadership role in increasing provider effectiveness by educating and promoting provider participation in various IEHP initiatives, including administrative cost effectiveness, member satisfaction (CAHPS), regulatory‑related, IEHP quality programs, and electronic solutions (EDI, EFT, EMR, provider portal, provider website, etc.).
Benefits
CalPERS retirement
457(b) option with a contribution match
Generous paid time off – vacation, holidays, sick
State‑of‑the‑art fitness center on‑site
Medical insurance with dental and vision
Paid life insurance for employees with additional options
Short‑term and long‑term disability options
Pet‑care insurance
Flexible spending account – health care/childcare
Wellness programs that promote a healthy work‑life balance
Career advancement opportunities and professional development
Competitive salary with annual merit increase
Team bonus opportunities
Pay Range
$80,059.20 USD annually – $106,059.20 USD annually
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