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Provider Relations Network Manager (PRNM) oversees the provider network, provider relationships, and quality of service delivery through coordination of long-term supports and services. The PRNM is responsible for a full range of provider relations and service interactions including but not limited to: recruitment, contracting, issue resolution, strategy development and execution, and contracted provider retention. Oversee the day-to-day operations of managing the agency’s provider network, this includes ensuring providers maintain compliance with programmatic standards, ensuring the quality of services delivered, and supporting the network. PRNM has the responsibility of ensuring the agency maintains an adequate network to deliver services, including negotiating direct service purchase (DSP) bids for in-home and community-based services for the entire agency. Manage and oversee a team that monitors, audits, and conducts surveys of the provider network. PRNM must maintain current knowledge of all programs and effectively relay pertinent information to the provider network. Facilitate provider network trainings and additional activities to support/improve provider network functions and relations.

Duties Include:

+ ​​Oversee the day-to-day operations of managing the agency’s provider network. This includes ensuring providers maintain compliance with programmatic standards, ensuring the quality of services delivered, and supporting the network with training, programmatic updates and other information as required for provider network support. Effectively manages the implementation of provider contracts, including contractual compliance in accordance with grant requirements.

+ Coordinates, manages, and audits the provider network for compliance in accordance with all program funding streams. Assess KPIs on a routine basis to ensure quality and timely service delivery. Manage compliance performance issues with providers to meet requirements through a Compliance Assurance Process (CAP). Develop, update and maintain operation SOP’s to support operation initiatives and compliance guidelines.

+ ​Maintain knowledge of fiscal impacts related to reimbursement negotiation and collaborate with the Finance and Clinical teams as needed. Collaborate with the Finance Department as needed related to provider claim issue resolutions.​

+ Act as a liaison with provider agencies to provide info on services, orientation, and training, Maintains excellent working relationships with provider network, other business partners, and internal leadership. PNM will attend external MDHHS meetings as necessary.

+ Other duties as assigned (to view the entire job description, please select the "download" button).

Qualifications

QUALIFICATIONS:

+ Bachelor degree in Business management, Administration or equivalent, Masters Preferred.

+ Must have 5 years of relevant experience with contracts/project management and networking. Preferred experience with MiChoice, AASA, and ICO contracts.

+ Excellent written, oral communication, organization, critical thinking and strong leadership skills.

+ Ability to meet strict deadlines with a high level of accuracy.

+ Strong negotiation skills, contract execution, computer skills in Word, Excel and Outlook required.

+ Preferred certification in contracts management - CPCM, CFCM or CCCM.

OUR INDUSTRY-LEADING BENEFITS CONSISTS OF:

Choice of 3 excellent next to zero cost Medical Plans including Dental and Vision.

401K - Agency contributes 50% match up to first 6% contribution.

Fitness and Wellness programs.

Excellent PTO package- Minimum 4 weeks accrual for the first year.

Get 10 paid holidays and 3 floating.

Mileage reimbursed for business travel.

Work schedules consist of hybrid, community-based, or office-based.

Our recruiting team would love to hear from you today! Please complete our on-line application and submit your resume for immediate consideration. The Area Agency on Aging 1-B is an Equal Opportunity and Affirmative Action Employer.