Provider Program Manager

TriWest Healthcare Alliance Corp.; Phoenix (AZ); Remote; USD 115,000 - 135,000; Full time

Benefits offered by this job

Medical, Dental and Vision Coverage

Paid time off

401(k) Retirement Savings Plan

Disability and life insurance

Tuition reimbursement

Paid volunteer time

Job summary

TriWest Healthcare Alliance Corp. is seeking a Provider Program Manager to lead design, implementation, and delivery of programs in provider services.

You will partner with C‑Suite and stakeholders to define objectives, plan execution, and ensure outcomes across value-based care, provider education, or credentialing. Requires a Bachelor's in Business/Healthcare Administration, US citizenship, and 7+ years in enterprise project management with healthcare experience.

Qualifications

• Bachelor's degree in business, healthcare administration, or related field; equivalent experience
• U.S. Citizenship; favorable DoD background investigation
• 7+ years managing enterprise projects; 5+ years in healthcare value-based care or credentialing
• Proven success designing and delivering value-based care or provider education programs
• Advanced verbal and written communication; ability to lead diverse teams
• Experience managing vendor/partnership relationships; proficient in MS Office
• Preferred PMP/PgMP certifications; DoD/VA/MHS/TRICARE experience

Responsibilities

• Design, develop and implement programs to meet contract requirements (value-based care, provider education, credentialing).
• Collaborate with C‑Suite and stakeholders to ensure objectives are well defined and executed.
• Lead business requirements and track progress; develop schedules and tracking templates.
• Monitor trends, identify risks, and report to leadership; manage cross‑functional projects.
• Build documents/tools to support goals; facilitate design sessions and action plans.

Skills

Communication skills

Leadership

Vendor management

Project management

Education

Bachelor's Degree in Business, Healthcare Administration, or related field

Master's Degree in Business, Healthcare Administration, or related field

Project Management Professional (PMP)

Program Management Professional (PgMP)

Tools

Microsoft Office Suite

Microsoft Project

Project Server

Visio

SharePoint

Job description

Profile

We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only).

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Veterans, Reservists, Guardsmen and military family members are encouraged to apply!

Job Summary

The Provider Program Manager is responsible for overseeing the design, implementation, and delivery of processes, programs, and policies in an assigned functional area within the provider services departments. The Provider Program Manager ensures that strategic, enterprise-wide programs are well defined, planned, tracked, and communicated in a consistent manner; is responsible for collaborating with C‑Suite executives and other stakeholders; and is responsible for deliverables that meet defined requirements and for utilizing project management best practices. The Provider Program Manager will function as both a subject matter expert (SME) and delivery lead and will be assigned to a specific functional area such as value‑based care, provider education or credentialing.

Education & Experience

Required

• Bachelor's Degree in Business, Healthcare Administration, or other related field, or equivalent experience
• U.S. Citizenship
• Must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation
• 7+ years of managing projects and/or programs at an enterprise level with at least 5 years in a healthcare related industry and specifically in value based care or alternative payment models provider credentialing, or provider education
• Demonstrated success in designing, implementing, and delivery of value-based care, provider education or provider credentialing programs
• Advanced verbal and written communication skills, with ability to lead and motivate diverse teams
• Experience managing vendor/partnership relationships
• Experience utilizing Microsoft Office Suite (Word, Excel, PowerPoint, Project, Access)

Preferred

• Master's Degree in Business, Healthcare Administration, or other related field
• Project Management Professional (PMP) certification
• Program Management Professional (PgMP) Certification
• Experience working with Department of Veterans Affairs and/or Military Health System/TRICARE

Key Responsibilities

• Performs as a subject matter expert by designing, developing and implementing assigned programs that meet contract requirements such as value-based care, provider education or credentialing.
• Develops effective collaborative relationships with TriWest’s inter and intra-departmental stakeholders and other SMEs, C‑Suite executives, and other leaders in Operations, Health Care Services, Provider Network, and IT to ensure that TriWest meets contractual requirements and fulfills organizational objectives.
• For value-based care program: Assists in the development of sophisticated health care economics models to evaluate the efficacy of various value-based care scenarios and models.
• Monitors industry trends related to value-based care, including other payer programs and government led programs and demonstrations.
• Researches, identifies, and reports potential risks and issues related to value-based care programs to organizational leadership.
• Works closely with assigned teams’ leadership and respective team members to ensure projects and programs are well defined, planned, executed, tracked, and communicated in a transparent, consistent, and effective manner. Acts as the lead on business requirement development for area of responsibility.
• Tracks, analyzes, and summarizes data for reporting, decision making, and follow-up action plans.
• Works with stakeholders and other subject matter experts to build documents and tools to support goals.
• Prepares meeting agendas to include meeting summaries and due outs.
• Builds project schedules and tracking templates to monitor progress.
• Facilitates solution design sessions and creates follow-up action plans.
• Performs first-level primary research and discovery to scale and optimize current operations.
• Partners with enterprise QPI team to develop project methodologies, processes, tools, and standards in support of maturing capabilities.
• Other duties as assigned.
• Regular and reliable attendance is required.

Competencies

Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapt to different styles; listen critically; collaborate.

Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.

Creativity / Innovation: Ability to develop unique and novel solutions to problems; view change as necessary.

Delegation Skills: Provide clear performance expectations for projects and ensure adequate access to resources for completion.

Empathy / Customer Service: Customer-focused behavior; helping approach, including listening skills, patience, respect, and empathy for another’s position.

Leadership: Successfully manage different styles of employees; provide clear direction and effective coaching.

Multi-Tasking / Time Management: Prioritize and manage actions to meet changing deadlines and requirements within a high volume, high stress environment.

Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail oriented.

Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues.

Technical Skills: Previous experience and demonstrated success leading and managing large and complex enterprise projects and programs. Proficient with Microsoft Project, Project Server, Visio, and SharePoint Services.

Working Conditions

• Works in standard office working conditions, with moderate travel
• Availability to work non-regular hours and long shifts as required

Company Overview

Taking Care of Our Nation’s Heroes.

It’s Who We Are. It’s What We Do.

Do you have a passion for serving those who served?

Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve!

Our job is to make sure that America’s heroes get connected to health care in the community.

At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.

DoD Statement

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Benefits

We’re more than just a health care company. We’re passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:

• Medical, Dental and Vision Coverage
• Paid time off
• 401(k) Retirement Savings Plan (with matching)
• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
• Tuition reimbursement
• Paid volunteer time

TriWest job postings typically include a salary range, which can vary based on the specific role and location, but generally this position ranges from around $115,000 - $135,000 per year.

Equal Employment Opportunity

TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that supports diversity at every organizational level, and we highly encourage candidates from all backgrounds to apply. Applicants are considered for positions based on merit and without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.