Supervisor Provider Relations
Fletcher Allen Health Care - Colchester, VT

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The Supervisor of Provider Relations is responsible for the management of the overall day to day functions of the External Provider Relations staff. The Supervisor will work closely with the Senior Network Profile Specialist regarding provider claim issues, provider profile changes, providers requesting to be contracted with VMC, and new processes to improve the service we provide our customers. Is responsible for managing and directing in the absence of the Director all day to day contracting systems and work associated with contracting including contract assessment and analysis, contract strategy, contract development, contract implementation, monitoring and negotiations of provider contracts for VMC. He/she is the primary contact for the Vermont Managed Care (VMC) Network Providers and Facilities, with regard to operational, contractual, and business issues relevant to both the VMC and the Fletcher Allen Health Care (FAHC) Payer Contracts. As the liaison between the VMC Network Providers / Facilities and FAHC's Clinical Departments / Medical Staff, and the VMC and FAHC contracted insurance plans, he/she provides superior service and advocacy on behalf of both VMC and FAHC providers while ensuring and maintaining continued collaborative working relationships between all parties. In this process, collaborative working relationships between Community Providers and FAHC are also established and fostered. This position researches all provider issues through to resolution and communicates results to the provider, payers, and VMC staff. Also responsible for project management of various VMC business projects and initiatives. While providing routine educational meetings and seminars for the VMC Network, he/she develops, maintains, and/or oversees education and marketing tools that include the VMC Provider Manual, the VMC "Partners in Care" Newsletter, the VMC and Fletcher Allen Preferred Web Sites, and healthcare conference and trade-show display table.

Education:

Bachelor's degree in healthcare related field, or an equivalent combination of education and directly related experience in healthcare and provider or payer relations. CPC Certification preferred.

Experience:

PLEASE NOTE : 2-5 years experience working with providers and hospitals and their contracted payers is required. Provider practice management experience leading and managing staff for at least 12-18 months is key.

When you put the patient first, everything else will follow.

Fletcher Allen Health Care - 18 months ago - save job - block
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