Provider Network Manager
Leidos, Virginia, MN, United States
Description
Leidos Health and Services Sector currently has an opening for a
Provider Network Manager
to work remotely. This is an opportunity to contribute to the Military OneSource mission, which provides 24/7 support services for military members and their families. The Military OneSource program serves as a "one source" for information, resources, education, referrals, and counseling to about 4.7 million participants worldwide.
Responsibilities
Provides overall oversight of the behavioral health counselor provider network.
Leads, directs, and manages Provider Network Supervisors’ workflows and performance to ensure effective service delivery.
Uses technical tools and applications to identify trends, issues, and recommendations for process improvements.
Oversees quality metrics and continuity of services; develops, implements, and maintains SOPs and workflows to meet or exceed SLAs and performance metrics.
Continuously assesses and collaborates to refine service delivery processes and procedures to optimize efficiency and customer satisfaction.
Monitors participant feedback scores and provider performance measures; develops and tracks provider scorecards to ensure high-quality, timely service delivery.
Monitors timely and accurate completion of provider documentation and billing submissions.
Provides mentoring, guidance, and supplemental training to Provider Network Supervisors.
Fosters strong working relationships with provider network subcontractors and the Leidos program management team to promote a unified, high-performing culture.
Provide operational oversight of the Provider Network to ensure compliant, high-quality service delivery.
Lead, direct, and manage Provider Network Supervisors, overseeing workflows, performance metrics, and service quality.
Provide guidance on escalated cases and handle escalated provider and client complaints, claims, and authorization issues.
Lead recurring operational meetings to review escalated cases, analyze data trends, and address matters requiring higher visibility.
Develop, implement, and maintain SOPs and workflows to meet or exceed SLAs and performance metrics.
Monitor counseling quality metrics, client feedback scores, and provider performance measures; develop and maintain provider scorecards.
Utilize tools such as MS Office applications and EHR systems to analyze performance data and provide recurring metric reports.
Track provider referral volumes to identify high-performing providers for incentives, low
o-volume providers, and those needing corrective action or removal from the roster.
Engage with provider network subcontractors to address performance concerns, contractual issues, and service improvements.
Mentor and provide supplemental training to Provider Network Supervisors to strengthen leadership and operational effectiveness.
Escalate high-visibility events and maintain required QA and QC documentation.
Foster collaborative relationships with subcontractors and program leadership to promote alignment, communication, and a high-performing team culture.
Perform additional duties and special projects as assigned based on business needs.
Basic Qualifications
Bachelor’s degree from an accredited university; 5+ years progressive experience working directly with provider relations networks specific to behavioral health.
Experience with network provider recruitment, gap analysis, credentialing, and onboarding; experience working with subcontractors in a management role.
Minimum of five years of supervisory or people management experience in a similar program environment.
Strong project management skills with the ability to deliver services within timelines, budgets, and quality standards.
Strong customer service skills and knowledge of call center operations.
Ability to build strong customer relationships and deliver solutions; strong business and financial acumen.
Ability to develop strategy, plan, prioritize work aligned to program goals, and deliver business solutions.
Ability to establish clear responsibilities, processes, and accountability for the team.
Ability to build effective teams and develop talent.
Ability to assist employees in meeting career and organizational goals; motivate and drive engagement with honesty and integrity.
Ability to achieve results under challenging circumstances and manage complex situations.
Proficiency in Microsoft Office applications (Word, Outlook, Excel) and web-based research and electronic documentation systems.
Strong analytical, organizational, and leadership skills.
U.S. citizenship and English fluency required.
Ability to pass criminal history, fingerprint background checks, and credential verification; maintain suitability investigations and clearances as required.
Proficient in navigating electronic systems, computer programs, and virtual service platforms.
This position requires a separate, quiet, private space to work from, with access to reliable high-speed internet hard-wired to the home (no tethering from mobile hotspot).
Preferred Qualifications
People leader management or supervisory experience.
Strong background in provider relations, including developing and maintaining a behavioral health provider network.
Subcontract management experience.
About Leidos
Leidos is an industry and technology leader serving government and commercial customers with digital and mission innovations. Headquartered in Reston, Virginia, with 47,000 global employees, Leidos has reported revenues around $16.7 billion for the fiscal year ending January 3, 2025. For more information, visit www.Leidos.com.
Pay Range
Pay Range $82,550.00 - $149,225.00. The Leidos pay range for this job level is a general guideline only and not a guarantee of compensation. Additional factors considered include responsibilities, education, experience, knowledge, skills and abilities, internal equity, market data, applicable bargaining agreements, and other applicable laws.
Pay and Benefits
Pay and benefits are fundamental to any career decision. Leidos offers compensation, health and wellness programs, income protection, paid leave, and retirement. Details are available at www.leidos.com/careers/pay-benefits.
SECURING YOUR DATA
Beware of fake employment opportunities using Leidos’ name. Leidos will never ask for payment-related information during the application process and will communicate through the Leidos.com system. If you suspect a fraudulent contact, email LeidosCareersFraud@leidos.com.
Commitment to Non-Discrimination
All qualified applicants will receive consideration for employment without regard to sex, race, ethnicity, age, national origin, citizenship, religion, disability, medical condition, genetic information, pregnancy, family structure, marital status, ancestry, domestic partner status, sexual orientation, gender identity or expression, veteran status, or any other basis prohibited by law. Leidos will also consider applicants with criminal histories consistent with relevant laws.
#Remote
#J-18808-Ljbffr
Leidos Health and Services Sector currently has an opening for a
Provider Network Manager
to work remotely. This is an opportunity to contribute to the Military OneSource mission, which provides 24/7 support services for military members and their families. The Military OneSource program serves as a "one source" for information, resources, education, referrals, and counseling to about 4.7 million participants worldwide.
Responsibilities
Provides overall oversight of the behavioral health counselor provider network.
Leads, directs, and manages Provider Network Supervisors’ workflows and performance to ensure effective service delivery.
Uses technical tools and applications to identify trends, issues, and recommendations for process improvements.
Oversees quality metrics and continuity of services; develops, implements, and maintains SOPs and workflows to meet or exceed SLAs and performance metrics.
Continuously assesses and collaborates to refine service delivery processes and procedures to optimize efficiency and customer satisfaction.
Monitors participant feedback scores and provider performance measures; develops and tracks provider scorecards to ensure high-quality, timely service delivery.
Monitors timely and accurate completion of provider documentation and billing submissions.
Provides mentoring, guidance, and supplemental training to Provider Network Supervisors.
Fosters strong working relationships with provider network subcontractors and the Leidos program management team to promote a unified, high-performing culture.
Provide operational oversight of the Provider Network to ensure compliant, high-quality service delivery.
Lead, direct, and manage Provider Network Supervisors, overseeing workflows, performance metrics, and service quality.
Provide guidance on escalated cases and handle escalated provider and client complaints, claims, and authorization issues.
Lead recurring operational meetings to review escalated cases, analyze data trends, and address matters requiring higher visibility.
Develop, implement, and maintain SOPs and workflows to meet or exceed SLAs and performance metrics.
Monitor counseling quality metrics, client feedback scores, and provider performance measures; develop and maintain provider scorecards.
Utilize tools such as MS Office applications and EHR systems to analyze performance data and provide recurring metric reports.
Track provider referral volumes to identify high-performing providers for incentives, low
o-volume providers, and those needing corrective action or removal from the roster.
Engage with provider network subcontractors to address performance concerns, contractual issues, and service improvements.
Mentor and provide supplemental training to Provider Network Supervisors to strengthen leadership and operational effectiveness.
Escalate high-visibility events and maintain required QA and QC documentation.
Foster collaborative relationships with subcontractors and program leadership to promote alignment, communication, and a high-performing team culture.
Perform additional duties and special projects as assigned based on business needs.
Basic Qualifications
Bachelor’s degree from an accredited university; 5+ years progressive experience working directly with provider relations networks specific to behavioral health.
Experience with network provider recruitment, gap analysis, credentialing, and onboarding; experience working with subcontractors in a management role.
Minimum of five years of supervisory or people management experience in a similar program environment.
Strong project management skills with the ability to deliver services within timelines, budgets, and quality standards.
Strong customer service skills and knowledge of call center operations.
Ability to build strong customer relationships and deliver solutions; strong business and financial acumen.
Ability to develop strategy, plan, prioritize work aligned to program goals, and deliver business solutions.
Ability to establish clear responsibilities, processes, and accountability for the team.
Ability to build effective teams and develop talent.
Ability to assist employees in meeting career and organizational goals; motivate and drive engagement with honesty and integrity.
Ability to achieve results under challenging circumstances and manage complex situations.
Proficiency in Microsoft Office applications (Word, Outlook, Excel) and web-based research and electronic documentation systems.
Strong analytical, organizational, and leadership skills.
U.S. citizenship and English fluency required.
Ability to pass criminal history, fingerprint background checks, and credential verification; maintain suitability investigations and clearances as required.
Proficient in navigating electronic systems, computer programs, and virtual service platforms.
This position requires a separate, quiet, private space to work from, with access to reliable high-speed internet hard-wired to the home (no tethering from mobile hotspot).
Preferred Qualifications
People leader management or supervisory experience.
Strong background in provider relations, including developing and maintaining a behavioral health provider network.
Subcontract management experience.
About Leidos
Leidos is an industry and technology leader serving government and commercial customers with digital and mission innovations. Headquartered in Reston, Virginia, with 47,000 global employees, Leidos has reported revenues around $16.7 billion for the fiscal year ending January 3, 2025. For more information, visit www.Leidos.com.
Pay Range
Pay Range $82,550.00 - $149,225.00. The Leidos pay range for this job level is a general guideline only and not a guarantee of compensation. Additional factors considered include responsibilities, education, experience, knowledge, skills and abilities, internal equity, market data, applicable bargaining agreements, and other applicable laws.
Pay and Benefits
Pay and benefits are fundamental to any career decision. Leidos offers compensation, health and wellness programs, income protection, paid leave, and retirement. Details are available at www.leidos.com/careers/pay-benefits.
SECURING YOUR DATA
Beware of fake employment opportunities using Leidos’ name. Leidos will never ask for payment-related information during the application process and will communicate through the Leidos.com system. If you suspect a fraudulent contact, email LeidosCareersFraud@leidos.com.
Commitment to Non-Discrimination
All qualified applicants will receive consideration for employment without regard to sex, race, ethnicity, age, national origin, citizenship, religion, disability, medical condition, genetic information, pregnancy, family structure, marital status, ancestry, domestic partner status, sexual orientation, gender identity or expression, veteran status, or any other basis prohibited by law. Leidos will also consider applicants with criminal histories consistent with relevant laws.
#Remote
#J-18808-Ljbffr