- Manage and coordinate the activities of the Provider Performance & Network Administration. Accountable for driving performance specific strategies to increase the probability of successfully achieving our goal of a high-performance network.
- Host and facilitate Provider Profile reviews with area providers to ensure transparency around individual provider results, and comparison of regions.
- Collaborate with CareScout leaders and CareScout Provider Relationship Managers to review regions provider's performance, including quality, cost, care gaps, and Person-Centered Care Survey.
- Perform continuous region surveillance of discount performance, access and availability, directory accuracy and customer satisfaction and develop/implement strategies to address deficiencies.
- Collaborate with Regional Provider Relationship Managers and various stakeholders to develop overall plan for improving region's provider performance.
- Analyze provider performance and profiling for interventions data.
- Review the evaluation and audits of provider rates, quality, unit cost, data integrity, and utilization trends and identify and propose improvement opportunities.
- Establish, execute, and monitor the network administration including ensuring rates are up to date, contract terms are shared with appropriate internal team, providers audited for data integrity, and are accurately displayed.
- Interface with all levels of the organization to ensure provider data accuracy.
- Develop and deliver provider orientation, training, and education materials.
- Assist in strategies to improve key performance indicators; analyze performance data and identify opportunities and performance drivers; coordinate with interdisciplinary teams to improve outcomes (e.g., Quality, Cost drivers, IT). Work cross functionally to ensure successful implementation of provider performance programs and agreements.
- Conduct contract reviews and amendments as required to maintain current and accurate measures, benchmarks and targets in accordance with regulatory bodies.
- Assist with deployment of providers in the network and education to delegate partner HCP and Credentialing vendor - self-service person-centered care management and reporting tools, value
- Ability to lead a team
- Complete ad-hoc projects as assigned/required.
- Bachelor's degree, Health or management related experience preferred.
- Minimum seven (7) years of experience with extensive provider networks, provider relations/contracting or Home Care or LTC, Home Care employee experience.
- Ability to understand individual and operational problems and identifying appropriate solutions.
- Demonstrated strategic and creative approaches to identifying and implementing solutions to complex issues and support requirements.
- Minimum two (2) years' leadership experience
- Excellent ability to present data and results to all audience levels
- Ability to travel 20%
- Strong ability to provide clear and detailed oral & written communication
- Analytical, problem solving and decision making skills
- Proven experience in critical thinking skills
- Ability to work collaboratively and independently in a matrix work environment.
- Competitive Compensation & Total Rewards Incentives
- Comprehensive Healthcare Coverage
- Multiple 401(k) Savings Plan Options
- Auto Enrollment in Employer-Directed Retirement Account Feature (100% employer-funded)
- Generous Paid Time Off - Including 12 Paid Holidays, Volunteer Time Off and Paid Family Leave
- Disability, Life, and Long Term Care Insurance
- Tuition Reimbursement, Student Loan Repayment and Training & Certification Support
- Wellness support including gym membership reimbursement and Employee Assistance Program resources (work/life support, financial & legal management)
- Caregiver and Mental Health Support Services
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Manager, Provider Network Performance Management - Watertown, United States - CareScout
2 weeks ago
Description
About CareScoutJoin us on a mission to simplify and dignify the aging experience. We are the children, siblings, neighbors, and friends of those navigating the fragmented and confusing system of long-term care. Our team is ferociously curious and relentless in our pursuit of a better system - and we are deeply committed to a sense of belonging for all, in all phases of life.
We're creating a new experience for care seekers and their families, bringing together long-term care options, non-healthcare resources, education, and human support into one place. We work hard, we have fun, we care about each other, and we share the mission. If this sounds like a place where you could thrive, join us
CareScout is a wholly owned subsidiary of Genworth Financial, Inc, a Fortune 500 provider of products, services and solutions that help families address the financial challenges of aging.
POSITION TITLE
Manager, Provider Network Performance Management
POSITION LOCATION
Remote (US)
YOUR ROLE
As the Provider Network Performance Management Manager for CareScout Services, you will play a critical role in the overseeing provider regions, monitoring and analyzing of CareScout Services Provider Performance Management & Data and Rate activities. Previous experience, skills, and expertise handling provider networks, alongside partnership and collaboration skills with provider relationships.
What you will be doing
Genworth employees make a difference in people's lives every day. We're committed to making a difference in our employees' lives.
