Manager Provider Operations
OUR WHY: 5-STAR SERVICE CULTUREAt Mejor Salud, it’s our commitment, our passion, and our culture that sets us apart. We don’t just talk the talk - we believe in it and live by it. We are revolutionizing the healthcare industry by focusing on quality, not quantity. Our core value is always to deliver 5-Star Service. And by doing so, we are successfully able to achieve our mission of Better Health.We are a preferred partner for driving value-based care adoption and delivering personalized, secure, and seamless healthcare experiences. We take great care of our team, patients, providers, and affiliates. To us, it’s about providing quality care for better outcomes! When our patients win with Better Health, Mejor Salud wins.
The Manager of Provider Operations will be responsible for maintaining and improving the performance of the Puerto Rico Network of Providers. Reporting to the Market Executive Director and in collaboration with various HQ teams, external medical offices, and vendors, support desired program outcomes for the market. This position will be expected to guide the team and achieve the assigned objectives within the following scope, as well as other assigned duties and activities that aid and leverage our team function.
Responsibilities include and are not limited to:
- Manage a market of affiliate providers in partnership with the market Executive Director.
- Work collaboratively with the Market Executive Director, the medical office team, Mejor Salud, and Votion's teams to support the success of Votion's programs.
- Oversee and manage the time, schedule, goals, and performance of the Puerto Rico coordinators Team.
- Facilitate at least biweekly 1:1 meetings with each team member and report on discussed performance, goals, and objectives to the market Executive Director.
- Provide day-to-day guidance to the provider coordinators' team. Lead weekly team meetings.
- Actively develop goals and objectives with team members and measure quarterly performance based on the actual completion/accomplishment of these goals.
- Maintain relationships with the Puerto Rico market medical office teams.
- Foster positive relationships within all Mejor Salud, MCS, and Votion's departments.
- Responsible for leading conversations around promotions and bonus recommendations with the Market Executive Director.
- Escalate corrective action and cause for termination actions to the market executive director and Sr. Director of Team Resources.
- Set standing meetings with the Market Executive Director to discuss market and team performance as well as personal and professional goals.
- Monitor and secure the market CHRA, Encounters, Health Profiles, Part C & D improvements, patient engagement and experience, and provider education projects among others per the annual MCS and Mejor Salud plan.
- Assist with closing identified HEDIS gaps and achieving specified Star measures for the IPA.
- Maintain close communication and coordination with HQ Quality leaders and the market Executive Director.
- Coordinate the market EMR pilot program. Supports the deployment of the EMR extraction process.
- Assure the coordinator's access to the company's proprietary portal to download and print forms for the clinic to distribute to members upon visit.
- Review, distribute, and modify as needed Gap reports (ie: data mining relevant to appointments, referrals, CHRA, etc.
- Coordinate with MCS and the medical office (s) vendor activities such as Mammography, Eye exams Screening. Assures the program coordinators are participating in the care gap vendor events.
- Coordinate Medication adherence initiatives as applicable.
- Assist in scheduling members for preventative diagnostic screening in accordance with MCS CHRA programs.
- Complex Care Management support - Responsible for utilizing research and investigative skills to assist medical offices with admission management, utilization management, and preventative care outreach to high-risk members.
Requirements and Skills:
- Bachelor’s degree in healthcare management, business administration, or related field preferred, or a combination of higher education and technical experience in related fields.
- At least 3 years of experience in a management position within healthcare; Provider Relations or Business Development
- Excellent written and verbal communication skills both in English and Spanish
- This is a hybrid role, working in the field and at home
- Must have reliable transportation and be able to travel regularly to clinics as needed
- Proven ability to work with Google Suite software or equivalent (MS Excel and MS Powerpoint)
- Ability to work independently with minimal supervision
- Financial skills including budgeting, forecasting, and justifying
- Proven leadership and organizational skills along with the ability to remain a team player
- Excellent organizational, time-management, and multi-tasking skills with strong attention to detail
- Ability to work in a shifting and fast-paced environment
- Must be able to work professionally with confidential information
- Ability to work cross-functionally with multiple teams
Due to the anticipated volume of responses, we will contact only those candidates who will most closely match our requirements
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Better Health Group00725, PR
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