Hybrid Community Supports Provider Relations Manager

at IEHP

• Job title: Community Supports Provider Relations Manager
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: $71,572 - $93,038 per year
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, Rancho Cucamonga, United States

About the role

• Community Supports Provider Relations Manager at IEHP developing and maintaining healthcare provider networks for service adequacy and compliance. Leading onboarding and engagement efforts in support of quality initiatives.

Responsibilities

• Responsible for developing and maintaining a robust network of potential and contracted Community Supports network providers to ensure service adequacy, quality, and compliance with federal, state, and local regulations.
• Serves as the primary liaison and subject matter expert for all CS services associated with their assigned providers, fostering strong partnerships to drive operational excellence.
• Lead provider engagement, onboarding, training, and performance improvement efforts.
• Support strategic initiatives to expand and strengthen the Community Supports network in alignment with IEHP’s mission and strategic goals.
• Recruit new CS Providers into IEHP Community Support Network as well as identify opportunities to develop the Community Supports network to meet IEHP quality metrics, service goals, and compliance standards.

Requirements

• Three (3) or more years of experience with customer service in a health services setting including Hospital, Managed Care, Medical Group, IPA, and/or HMO
• Experience with managed care
• Experience working in the community with community-based organizations (CBO’s)
• Bachelor's degree from an accredited institution required
• In lieu of the required degree, a minimum of four (4) years of additional relevant work experience in Community Supports is required for this position.
• Master’s degree from an accredited institution preferred
• Must have a valid California Driver’s license and valid automobile insurance.
• Must qualify and maintain driving record to drive company vehicles based on IEHP insurance standards of no more than three (3) points.
• Knowledge of Community Support Services
• Working knowledge of Medical Group, IPA, CBO’s and HMO operations
• Proficiency in utilization of all Provider Services databases and systems
• Strong organizational skills.
• Excellent written and verbal communication and interpersonal skills
• Microcomputer Applications (Microsoft Word and Excel, Access Preferred) for use in all aspects of an office environment
• Skilled data input
• Skills in proactively engaging with providers and staff to determine root cause and address business issues (such as administrative, regulatory and customer service matters)
• Training skills to educate providers and provider staff as needed, which may include counseling providers diplomatically, while retaining a positive working relationship
• Skills in network development, by monitoring and enforcing company policies and procedures, while increasing Provider effectiveness by educating and promoting participation in various IEHP initiatives.

Benefits

• Competitive salary
• State of the art fitness center on-site
• Medical Insurance with Dental and Vision
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development
• Wellness programs that promote a healthy work-life balance
• Flexible Spending Account – Health Care/Childcare
• CalPERS retirement 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance