Manager, Provider Network (BMWSI)

HealthCare Partners, IPA and HealthCare Partners, MSO together comprise our health care delivery system providing enhanced quality care to our members, providers and health plan partners. Active since 1996, HealthCare Partners (HCP) is the largest physician-owned and led IPA in the Northeast, serving the five boroughs and Long Island. Our network includes more than 10,000 primary care and specialist physicians delivering services to over 200,000 members enrolled in Commercial, Medicare and Medicaid products. Our Management Services Organization employs over 200 skilled staff professionals dedicated to ensuring practices deliver the highest quality of care to their patients while efficiently utilizing healthcare resources.

HCP’s vision is to be recognized by members, providers and payers as the organization that delivers unsurpassed excellence in healthcare to the people of New York and their communities. We pride ourselves on selecting the most qualified candidates who reflect HCP’s mission of serving our members by facilitating the delivery of quality care.

Interested in joining our successful Garden City Team? We are currently seeking a Manager, Provider Network to oversee our BMWSI (Bronx, Manhattan, Westchester County, and Staten Island) territory.

Position Summary: Reporting to the Director of Network Solutions, the Provider Network Manager (PNM) has accountability for network performance within an assigned geographic territory. This position leverages analytics to provide information, insight, and solutions that contribute to the strategic planning, decision-making, goal setting, and performance management of the HCP network. Leading a team of Provider Relations Representatives, the PNM develops and implements strategic population health objectives for their territory in order to:

• Increase provider engagement and satisfaction
• Improve provider financial performance and cost of care goals
• Improve provider Quality performance and member health outcomes
• Facilitate provider success with HCP

The Provider Network Manager is responsible for proactively building and maintaining relationships with HCP providers to progress the organization’s value proposition, and alignment with corporate objectives.
Essential Position Functions/Responsibilities:

• Engage directly with network providers and staff to drive population health and value based care success.
• Develop and implement continuous improvement strategies within assigned territories to increase provider engagement and performance
• Aggregate and maintain an up to date repository of provider information for assigned territories
• Proactively develop and maintain strong working relationships with assigned providers through regular onsite (and remote/telephonic) touchpoints, as required; ability to work up to 80% in the field.
• Utilize key performance data to identify provider specific opportunities and develop individualized improvement plans.
• Collaborate with office stakeholders to assess current workflows, implement best practices, and support the completion of HCP related objectives as needed.
• Collaborate with cross-functional teams to ensure successful implementation of provider performance programs and agreements.
• Develop and present materials to facilitate meaningful, value added provider touchpoints (performance opportunities, training materials, provider education, best practice workflows, etc…)  
• Review territory progress on an ongoing basis and update strategic plans to meet identified goals.
• Identify common issues affecting provider networks; collaborate with Network Relations leadership team to develop solutions.
• Promote network adoption of technology solutions (i.e. provider portal).
• Collaborate with HCP’s Quality and Medical Management teams to ensure quality assurance monitoring of PCP’s.
• Coordinate and execute internal monthly reporting and strategy 360 sessions with relevant HCP stakeholders.
• Participate in multidisciplinary teams to explore, develop, and implement new initiatives.
• Communicate and support new initiatives at the provider level.
• Aggregate provider feedback and identify ways for HCP to increase value to providers.
• Research and solve provider issues. Communicate resolutions within allocated timeframe.

Lead, manage and mentor direct reports; provide oversight and direction to direct reports in accordance with the organization’s policies and procedures.

• Work with Human Resources to recruit, interview, hire and employ new teammates.
• Utilize “Monday” CRM tool to ensure successful prep, execution, and follow-up of engagements (for both PNM and direct reports), identify training/coaching opportunities for direct reports, facilitate reporting at 360 sessions, and additional adhoc request.  
• Perform other duties as assigned.

Qualification Requirements:
Skills, Knowledge, Abilities
 

• Ability to analyze data to identify and prioritize practice opportunities
• Ability to synthesize opportunities into digestible presentations and achievable plans
• Ability to interface with physicians and staff in a professional and positive manner to create alignment and achieve common objectives
• Proven ability for creative problem solving
• Strong customer service and interpersonal “soft-skills”
• Strong knowledge of primary care office operations and managed care models.
• Strong understanding of Medical Loss Ratio (MLR), HCC, Stars, HEDIS and QARR and other population health/value based KPI’s
• Proven ability to manage multiple projects simultaneously
• Proven ability to perform against company identified performance targets
• Ability to self-direct, work well independently (with minimal supervision) and as a team
• Excellent oral and written communication/ presentation skills
• Skilled in Microsoft Office suite including PowerPoint and Excel
• Valid Driver’s License and Motor Vehicle Insurance

Training/Education:
 

• Bachelor’s degree in healthcare, business administration or related field required.
• Masters preferred
• Clinical disciplines highly considered

Experience:

• Two or more years’ experience in HMO, IPA or medical group, Physician Management Company, or other managed care organization.
• Consulting or Account Management experience preferred
• Clinical or practice operations experience highly considered
• Client relations experience valued. Provider relations experience preferred

Base Comp Range: $95,000-$110,000 annual
Bonus - Up to 10% of base salary based on organizational performance

HealthCare Partners, MSO provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, HealthCare Partners, MSO complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
The above position information is intended to describe the general nature and level of work being performed by the job incumbent(s) and is not to be considered an all-encompassing description of all responsibilities, duties, and skills required.