Network Performance & Provider Relations Lead

CareMore Health; Tucson (AZ); On-site; USD 81,000 - 122,000; Full time

Job summary

CareMore Health is seeking a Network Support Manager to optimize the provider network for access, quality, compliance, and performance. You will drive operational execution, resolve network issues, engage providers, and align with value-based goals.

The role requires at least a BA/BS with 3+ years in health care, provider relations, contracts, and reimbursement. MBA or related grad degree is preferred, with compensation range discussed below.

Qualifications

• BA/BS degree required
• MBA/MHA or related graduate degree strongly preferred
• Experience in health care provider relations, contracts, and reimbursement is a plus
• Knowledge of value-based care models and risk adjustment is expected

Responsibilities

• Oversee day-to-day training and guidance within the department and help resolve issues
• Analyze and coordinate strategies to administer facility provider contracts across multiple lines of business
• Create tools to assist contract implementation and administration
• Interface with providers on contractual obligations, education, and operations manual updates
• Partner on projects to ensure accurate facility and provider reimbursement policies and procedures

Skills

Medicare/Medicaid knowledge

CMS quality programs

Claims analysis & dashboards

Provider contracting

EHR/workflow navigation

Education

BA/BS degree

MBA/MHA or related graduate degree

Tools

EHR systems

Job description

CareMore Health is seeking a Network Support Manager to optimize the provider network for access, quality, compliance, and performance. You will drive operational execution, resolve network issues, engage providers, and align with value-based goals.

The role requires at least a BA/BS with 3+ years in health care, provider relations, contracts, and reimbursement. MBA or related grad degree is preferred, with compensation range discussed below.