Manager, Provider Relations

2 weeks ago

Miami, Florida, United States Independent Living Systems Full time

We are seeking a Manager, Provider Relations (IDD) to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.

About the Role:

The Manager, Provider Relations (IDD) plays a critical role in fostering and maintaining strong partnerships with providers who deliver services to individuals with intellectual and developmental disabilities (IDD). This position is responsible for ensuring that provider networks are robust, compliant, and aligned with organizational goals to deliver high-quality care. The manager will lead efforts to resolve provider issues, facilitate communication, and support provider development initiatives to enhance service delivery. By collaborating closely with internal teams and external stakeholders, this role ensures that providers meet regulatory requirements and contractual obligations. Ultimately, the Manager, Provider Relations (IDD) drives continuous improvement in provider engagement and satisfaction, contributing to better outcomes for individuals served within the health care system.

Minimum Qualifications:

  • Bachelor's degree in Health Care Administration, Social Work, Public Health, or a related field.
  • Minimum of 5 years of experience in provider relations, network management, or a related role within the health care or IDD services sector.
  • Strong knowledge of intellectual and developmental disabilities service delivery systems and regulatory requirements.
  • Relevant experience may substitute education requirement on a year-for-year basis. 

Preferred Qualifications:

  • Master's degree in a relevant field such as Health Administration, Social Work, or Public Health.
  • Experience working with Medicaid or other government-funded health care programs.
  • Familiarity with quality improvement methodologies and data analysis tools.
  • Proven leadership experience managing teams or projects within a health care setting.

Responsibilities:

  • Develop and maintain strong relationships with IDD service providers to ensure effective communication and collaboration.
  • Monitor provider performance and compliance with contractual and regulatory standards, addressing any issues proactively.
  • Lead provider network development initiatives, including recruitment, training, and retention strategies.
  • Serve as the primary point of contact for provider inquiries, concerns, and dispute resolution.
  • Collaborate with internal departments such as care management, to align provider services with organizational objectives.
  • Analyze provider data and feedback to identify trends and opportunities for improvement.
  • Coordinate provider meetings, training sessions, and informational events to support ongoing education and engagement.
  • Ensure timely and accurate documentation of provider interactions and activities in relevant systems.

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