Market Manager

7 days ago

Columbus, Ohio, United States Trinity Health Full time

About the Job: We are seeking a highly skilled Market Manager - Provider Relations and Network Development to join our team at Trinity Health. This role will be responsible for the strategic oversight of a geographic area or market of Provider Relations Managers.

Key Responsibilities:

  • Develop and implement a network development plan for multiple regions.
  • Work with senior leadership to design, develop and implement value-based programs (APM) that meet and reward quality and meet the goals of triple AIM.
  • Manage and support staff across an area/market to ensure departmental and company-wide goals are met.
  • Responsible for supporting the CIN governance structure to ensure actions for the board are executed upon a timely and reportable fashion.
  • Leads expansion opportunities into new states to ensure CMS adequacy and product salability by leveraging Quest Analytics and Zelis (or related tool) to benchmark against competitors.
  • Supports applicable CIN committee by providing network adequacy, capacity, and participation information and developing strategies related to filling gaps and growing the network.
  • Manages the relationship with Trinity/Mount Carmel ministries to ensure alignment of enterprise goals of triple AIM. Participates in leadership meetings at the MediGold and enterprise level as needed.
  • Enhance the engagement and partnership between the plan and its provider partners through effective leadership of the Joint Operating Committees (JOC).
  • Manages staff relations including performance management, staff satisfaction, and conflict management. Performs and oversees scheduling, recruitment, payroll, and student engagements.
  • Monitors departmental budgets, regulatory compliance, departmental contracts, and vendor relations.
  • Responsible for the daily activities of the provider network staff, which may include network development, contracting, credentialing, provider relations, and provider services.

Requirements:

  • Bachelor's Degree in business administration, finance, health administration or similar field preferred.
  • Licensure/Certification: None.
  • 5 or more years of relevant work experience in health plan provider relations including experience in leadership roles.
  • Effective Communication Skills.
  • Ability to supervise, lead and motivate colleagues in a team-building collaborative atmosphere.
  • Demonstrated ability to influence and create solutions when complex issues arise.
  • Demonstrated ability to identify areas of opportunity within Provider networks for improving overall efficiency and quality.
  • Working knowledge of protocols and procedures of Centers For Medicare and Medicaid Services.
  • Proven ability to work effectively with internal and external multi-disciplinary teams and key internal/external stakeholders across the organization.
  • Proven track record of managing multiple priorities and executing tasks within tight timeframes.
  • Experience in identifying and executing process improvement needs.
  • Effective Communication Skills.
  • Must possess a high degree of motivation, initiative, and organizational ability.
  • Valid driver's license.
  • Requires use of a personal vehicle with valid auto insurance.

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