Providor Network Manager

Woodlands Behavioral Healthcare Network; Cassopolis (MI); On-site; USD 60,000 - 90,000; Full time

Job summary

Woodlands Behavioral Healthcare Network seeks a Provider Network Manager to liaise with network providers, monitor compliance, and drive credentialing and policy implementation. You will support site visits and trainings while coordinating with the Contract Manager on compliance matters.

You will need a strong background in behavioral health, excellent communication, and the ability to manage multiple provider relationships across state regions.

Qualifications

• Associates degree required; minimum of 2 years in behavioral health settings preferred.
• Strong written and verbal communication; ability to train and coordinate with providers.

Responsibilities

• Identify, manage, and maintain a quality provider network.
• Conduct provider orientations and network meetings.
• Complete credentialing for external providers.
• Monitor compliance with state and local requirements.
• Serve as liaison between providers and Contract Manager for compliance issues.
• Attend local, regional, and state work groups; participate in user groups.

Skills

Verbal communication

Written communication

Organizational skills

Microsoft Windows proficiency

Education

Associates degree

Tools

Word

Excel

Outlook

PowerPoint

Teams

Job description

PROVIDER NETWORK MANAGER - POSITION OVERVIEW:The Provider Network Manager serves as an agency liaison to network providers who service Woodlands Behavioral Healthcare clients. This is accomplished by monitoring the compliance of service providers, facilitating meetings with service providers including but not limited to providing trainings, developing, implementing, and maintaining policies and procedures, and preparing audits as requested. The Provider Network Provider is also responsible for locating potential new service providers.POSITION RESPONSIBILITIESIdentify, manage, and maintain a quality provider network with the composition, structure, capacity, and characteristics necessary to ensure sufficient availability of providers and afford individuals the opportunity for choice and consideration.Conduct New Provider Orientations and Quality Provider Network meetings.Completes credentialing for all external providers.Monitor the compliance of service providers to state and local requirements to assure the highest quality of services to individuals served by WBHN.Serve as a liaison between service providers and the Contract Manager as relevant compliance issues arise or are otherwise identified.Consult and assist providers when a CAP is required due to non-compliance or as requirements change.Conduct provider site visits and reviews.Develop, implement, and maintain policies and procedures (and associated documents) related to role.Attend all local, regional, and state work groups related to provider network.Participate in the PCE user group meetings to represent provider network.Other duties as assigned.QualificationsMinimum QualificationsAssociates degree Minimum of 2 years’ experience professional work in behavioral healthKnowledge of the principles of continuous quality improvement, contracting, compliance, and risk managementAdvanced computer skills including word processing, spreadsheetsValid driver's licensePREFERRED QualificationsSound understanding of management processes relative to organizing, planning, implementing, and evaluating along with strong oral and written communication skills.Access to reliable transportationAny combination of education, training and experience providing the required knowledge, skills, and abilities to perform the essential functions of the job will be considered.Required Skills & AbilitiesExperience in a CMHSP setting.Excellent verbal and written communications skillsWorking knowledge of Microsoft Windows including Word, Excel, Outlook, PowerPoint, and Teams applicationsAbility to effectively organize and prioritize work assignments.Ability to effectively interact with various teams within WBHN as well as external provider organizations.