Senior CHC Partnerships & Ombudsman

Neighborhood Health Plan of Rhode Island; Smithfield (RI); On-site; USD 70,000 - 100,000; Full time

Job summary

Neighborhood Health Plan of Rhode Island is seeking a Community Health Center Relationship Manager/Ombudsman to oversee relationships with Rhode Island CHCs, acting as a liaison to cultivate, manage, and strengthen connections with CHC leadership. The role focuses on fair issue resolution and ensuring resources address CHC needs efficiently.

The position requires 5+ years in managed care or related healthcare roles, strong analytics, and excellent communication skills.

Qualifications

• Bachelor's degree in Health Admin, Business Admin, Public Health, or equivalent experience.
• 3+ years in managed care, healthcare organizations, provider relations with FQHCs.
• Knowledge of Medicaid/Medicare reimbursement, provider billing, claims operations, contracts, and regulations.
• Strong analytical, problem-solving, project management and organizational skills.
• Advanced proficiency in Microsoft Office Suite (Word, Excel, Outlook).
• Willingness to travel with reliable transportation; valid driver's license and insurance.

Responsibilities

• Serve as single point of contact for CHC leadership on Neighborhood operations.
• Interface with Neighborhood leadership for updates and CHC concerns.
• Regularly interact with CHC executives to build relationships and support their mission.
• Triage CHC needs and ensure timely resolution of issues.
• Support CHCs' member care, outreach and promotion efforts.
• Lead internal and external meetings to raise awareness and resolve issues.
• Establish regular CHC visits and operations meetings including staff education and training.
• Identify patterns of organizational issues and develop solutions.
• Contribute to organizational policies affecting CHC network.
• Coordinate escalated issues with partners internally and externally.
• Keep management informed of critical CHC issues.
• Represent the organization at RI HCA and CHC events.

Skills

Analytical thinking

Problem solving

Project management

Organizational skills

Communication

Relationship management

Education

Bachelor's degree in Health Admin / Business / Public Health

Tools

Microsoft Office Suite

Cognos

Salesforce

Job description

Neighborhood Health Plan of Rhode Island is seeking a Community Health Center Relationship Manager/Ombudsman to oversee relationships with Rhode Island CHCs, acting as a liaison to cultivate, manage, and strengthen connections with CHC leadership. The role focuses on fair issue resolution and ensuring resources address CHC needs efficiently.

The position requires 5+ years in managed care or related healthcare roles, strong analytics, and excellent communication skills.