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    Provider Relations Manager - Houston, United States - Innovista Health

    Innovista Health
    Innovista Health Houston, United States

    3 weeks ago

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    Description

    Job Description

    Job DescriptionDescription:

    Do you wake up every morning inspired to solve problems and make a meaningful impact in healthcare? If so, we want to hear from you.

    At Innovista Health, we're leading the effort to drive transformative change in healthcare. We are a full-service value-based care and managed service organization that partners with independent providers to help them navigate, succeed, and thrive in value-based care.

    Founded in 2013, Innovista Health offers solutions for providers at every point along the continuum of value-based care, ranging from care management, provider/ACO enablement, and quality improvement to performance insights, reporting, and managed administrative/payment services.

    While Innovista Health's main offices are in Oak Brook, IL and Houston, TX, we have remote employees throughout the US.

    We're thrilled to announce a dynamic opportunity for you to become an integral part of our Houston, Texas team. As a hybrid contributor, you'll play a key role in pioneering a pathway toward a more streamlined and effective healthcare system.

    JOB SUMMARY:

    This position exists to manage the provider network, which includes the administrative, provider education and provider resolution functions related to the provider network; manage the Provider Relation Representatives who act as a liaison between contracted payers, providers and ancillary providers to promote superior customer service in the area of Provider Relations.

    DUTIES AND RESPONSIBILITIES:

    • Lead and coordinate all provider relations activities, including education, reporting, and network development. This includes direct and indirect responsibilities aligned with the organization's strategic goals.
    • Ensure timely completion of all provider interactions, including orientations, site visits, and accessibility studies, while also evaluating and improving the network's accessibility and availability.
    • Assist in policy development, particularly around the Medicare Shared Savings Program and other risk-sharing programs, and provide direction and training to all providers in the network.
    • Oversee daily network operations in collaboration with the Market leadership and Medical Management teams, reinforcing action plans for both the network and individual providers.
    • Manage a dynamic Provider Relations team responsible for recruiting and developing network providers, fostering a strategic vision that underscores the department's importance in the organization's success.
    • Collaborate with Market leadership on provider performance measures, communication, and satisfaction surveys. Utilize these tools to manage relationships, meet payer requirements, and train staff.
    • Keep open lines of communication with all stakeholders, including providers, payers, and ACO Board, while ensuring the provider database and documentation are current and comprehensive.
    • Aid in the creation and implementation of provider training programs, handle complaints from providers and members and anticipate provider needs for proactive issue resolution.
    • Cultivate and maintain professional relationships within the healthcare community, including hospitals, physician offices, ancillary providers, and contracted health plans.
    • Keep a well-organized and updated database of all participating providers and the payer contracts they are associated with.
    Requirements:
    • Bachelor's degree or equivalent experience.
    • 5-7 years of relevant professional experience, including healthcare services/managed care/consulting, with a minimum of 3 years experience with delegated commercial models.
    • Proficiency in MS Office Applications and an aptitude to learn department-specific software systems.
    • Ability to effectively communicate technical concepts with team members and basic business concepts with internal customers.
    • A valid Driver's License and a vehicle are required. Must be able to travel at least 30% for client meetings within Texas.

    BENEFITS:

    We are committed to creating a culture where everyone feels important, welcomed, and included. We demonstrate this commitment by offering a comprehensive benefits package that fosters opportunities for growth and advancement and supports the physical, mental, and financial wellbeing of our team members.

    HEALTH & WELLBEING

    • A choice health coverage, including HMO and PPO, plus Flexible Spending Account (FSA) and Health Savings Account (HSA) options
    • Dental and vision coverage
    • Company-paid benefits (short- and long-term disability, employee life, and accidental death and dismemberment)
    • Employee Assistance Program
    • Discounts and perks on gym memberships, shopping, travel, recreation, and more.

    FINANCIAL GROWTH

    • A yearly discretionary bonus
    • 401(k) with a company match
    • Rewarding employee referral bonuses

    WORK/LIFE BALANCE

    • Generous paid time off policy that increases with tenure
    • Nine paid company holidays + three Diversity Days
    • Paid Parental Leave (up to 6 weeks, subject to applicable waiting period)
    • Potential to work hybrid or remote and/or create a flexible work schedule (role specific)

    JOB SATISFACTION & ADVANCEMENT

    • Clear career advancement and growth pathways
    • Continuous education opportunities
    • Diversity, Equity & Inclusion Committee with various Business Resource Groups you can join
    • Company-wide socials and gatherings
    • "Dress for Your Day" policy
    • An open-door policy that encourages direct communication with our CEO and upper management, fostering transparency and inclusivity in our work culture

    Benefits may be subjected to an applicable waiting period.

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