Provider Relations Manager

Your opportunity  

As our Provider Relations Manager, you play a critical role in steering the national Provider Relations department towards excellence. Your responsibilities encompass hiring, training, coaching, and assessing the performance of the Provider Relations staff, ensuring they are aligned with our mission and values. You are pivotal in facilitating team development with a focus on collaboration and process refinement, crafting and upholding policies, processes, and procedures to meet both internal and external standards. Your leadership ensures our Provider Relations team delivers a customer-centric experience, fostering strong relationships with providers, enhancing retention, and continuously improving our service quality. Your strategic insight into provider interactions, your ability to identify service enhancement opportunities, and your leadership in strategic initiatives are invaluable in our pursuit of organizational excellence. 

What you will do 

• Responsible for the national Provider Relations department.  
• Functions as the primary liaison for the physician network, serving as a centralized contact and taking ownership of issues while remaining responsive to physician concerns.  
• Demonstrates proficiency in payer relations, roster management, and credentialing. 
• Hires, trains, coaches, and evaluates the performance of the Provider Relations staff.  
• Facilitates individual and team development focused on collaboration and process improvement.  
• Develops and maintains policies, processes, and procedures to meet internal and external standards and ensures staff adhere to standard operating procedures.  
• Leads the Provider Relations team in creating a customer-focused, provider experience by listening to the customer and providing timely, clear, and consistent communication.    
• Create customer loyalty and improve retention by building strong relationships with providers by setting reasonable expectations, addressing issues timely, and delivering exceptional service aligned with Vytalize values.  
• Create a journey map of the providers’ interactions with the organization to evaluate different user scenarios and identify gaps.  
• Measures and reports on operational performance, identifies trends, and implements preventive actions.  
• Conducts internal routine audits and implements appropriate action.  
• Delivers strategic communications to providers.  
• Coordinates escalated claim disputes and all necessary research in a timely and effective way.  
• Coordinates root cause analysis of issue resolution.  
• Develops and implements tracking tools to ensure timely issue resolution and compliance with all applicable standards.  
• Oversees appropriate and timely intervention/communication when providers have issues or complaints (e.g., problems with claims, roster participation, credentialing, reimbursement methodologies, and provider website).  
• Drive focused strategic outreach with Providers to support Vytalize organizational initiatives 
• Strong communication, organizational, and time management skills. 
• Proficient in relationship management and customer service. 
• Expertise in root cause analysis and complex issue resolution. 
• Knowledge of Value-Based and ACO payment methodologies. 
• Familiarity with credentialing processes and payer/ACO roster management. 
• Experience with Medicare Fee-for-Service, ACO REACH, MSSP, and Commercial/Medicare Advantage programs. 
• Excellent communication, leadership, and problem-solving skills. 
• Demonstrated ability to drive organizational growth and meet operational goals. 
• Financial acumen with experience in budget management and reporting. 
• Current awareness of healthcare industry trends and regulatory changes. 
• Entrepreneurial spirit, a sense of ownership and comfortable operating in ambiguity 
• Solution oriented with the ability to think strategically and creatively in decision-making 
• Strong work ethic to exceed expectations and goals 
• Coachable and able to take direction and feedback well, yet being forward-thinking to challenge the status quo 
• Ability to act with integrity, professionalism, and confidentiality. 
• Proficient with Microsoft Office Suite or related software. 

Perks/Benefits 

• Competitive base compensation 
• Annual bonus potential 
• Health benefits effective on start date; 100% coverage for base plan, up to 90% coverage on all other plans for individuals and families  
• Health & Wellness Program; up to $300 per quarter for your overall well-being available on start date  
• 401K plan effective on the first of the month after your start date; 100% of up to 4% of your annual salary 
• Unlimited (or generous) paid "Vytal Time", and 5 paid sick days after your first 90 days 
• Company paid STD/LTD 
• Technology setup  
• Ability to help build a market leader in value-based healthcare at a rapidly growing organization  

Please note at no time during our screening, interview, or selection process do we ask for additional personal information (beyond your resume) or account/financial information.  We will also never ask for you to purchase anything; nor will we ever interview you via text message. Any communication received from a Vytalize Health recruiter during your screening, interviewing, or selection process will come from an email ending in @vytalizehealth.com