Partners In Recovery LLC
Manager - Provider Network Management Department Location: Port Huron, MI More..
Partners In Recovery LLC, Port Huron, Michigan, us, 48061
Location: 2186 Water Street, Port Huron, MI, 48060, United StatesBase Pay: $61200.00 / YearEmployee Type: Full TimeContact Information
Name: HRPhone: (810) 216-9425Description
Essential Functions
The Manager of the Provider Network Management Department is an administrative position with responsibility in providing direction for provider network management activities for the provider organizations that deliver public behavioral health services in the counties of Genesee, Lapeer, Sanilac, and St. Clair and their contract agencies.Provide training, guidance, and support to the Network Management Team and Network Providers.Chair the PIHP Provider Network Committee and Privileging & Credentialing Committee.Member of the Quality Improvement Committee.Review Privileging and Credentialing initial and renewal applications and manage process for tracking, notifications, and updates.Provide support for external audits including reviewing document submissions, providing presentations, and developing recommendations on Corrective Action Plans.Manage provider contracts.Oversee Policy and Procedure development and ongoing review.Manage Medicaid bulletin and proposed policy reviews.Oversee process for monitoring provider service contracts.Manage procurement activities including requests for proposals.Supervision of Provider Network Management staff.Minimum Qualifications
Master’s Degree in behavioral health or related fieldExperience in the area of Contracts or Provider Network ManagementTwo years of experience supervising staffExperience working at Pre-Paid Inpatient Health Plan (PIHP), Community Mental Health (CMH) or SUD provider agencyExperience in writing reports, analyzing data and administrative projectsAbility to be a “work leader” (of a person or function), or advise othersExperience in managing projects and teamsExcellent organizational and writing skillsDemonstrated knowledge of Microsoft Word and ExcelAbility to exercise some flexibility in problem solving, when expected results are clear and generally set by others, provided certain outcomes are avoidedIngenuity is required to adapt, alter, or improvise alternatives when unexpected situations occurAbility to exercise discretion and some flexibility in selecting an optimal solution from established alternatives to obtain the desired outcomeAbility to use or exert influence in a work processAbility to provide, exchange or explain information which conveys an opinion or evaluation of the facts or analysesAbility to develop and/or maintain effective work relationships with new, established, or non-receptive individuals/organizations through tact, diplomacy, and persuasionBasic knowledge of MDHHS reportingBasic knowledge of State of Michigan Medicaid Provider ManualValid State of Michigan Driver’s LicenseMust have access to transportationPreferred QualificationsFive years of experience supervising staffFive years of experience working with a Pre-Paid Inpatient Health Plan (PIHP)Experience in privileging and credentialingExperience with Microsoft PowerPointAdvanced knowledge of MDHHS reportingAdvanced knowledge of State of Michigan Medicaid Provider ManualSummary
Region 10 is committed to being a premier employer by enhancing the lives of our team and supporting their growth as people and professionals. We provide competitive wage scales that reward experience and performance, ongoing career development and training opportunities, excellent health coverage, generous paid time off with additional performance-based incentives, 13 paid holidays, flexible scheduling, and a comprehensive benefit program.NOTICE TO APPLICANTS
When applying, be sure to include evidence that the minimum qualifications are met (resume, copy of license, copy of educational transcripts, description of years of experience, skill-based experience/training, letters of reference, etc.).This position will be hired as employment-at-will.Any offer of employment is contingent upon a Criminal Background Check, as well as a 5 Panel Drug Screen.Region 10 PIHP embraces an employment environment that promotes recovery and discovery, a person-centered approach to treatment/services, and cultural competence. An employee in this or any position is expected to support the employment environment.Region 10 PIHP provides equal employment opportunities (EEO) to applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Region 10 PIHP complies with applicable state and local laws governing nondiscrimination in employment.
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Name: HRPhone: (810) 216-9425Description
Essential Functions
The Manager of the Provider Network Management Department is an administrative position with responsibility in providing direction for provider network management activities for the provider organizations that deliver public behavioral health services in the counties of Genesee, Lapeer, Sanilac, and St. Clair and their contract agencies.Provide training, guidance, and support to the Network Management Team and Network Providers.Chair the PIHP Provider Network Committee and Privileging & Credentialing Committee.Member of the Quality Improvement Committee.Review Privileging and Credentialing initial and renewal applications and manage process for tracking, notifications, and updates.Provide support for external audits including reviewing document submissions, providing presentations, and developing recommendations on Corrective Action Plans.Manage provider contracts.Oversee Policy and Procedure development and ongoing review.Manage Medicaid bulletin and proposed policy reviews.Oversee process for monitoring provider service contracts.Manage procurement activities including requests for proposals.Supervision of Provider Network Management staff.Minimum Qualifications
Master’s Degree in behavioral health or related fieldExperience in the area of Contracts or Provider Network ManagementTwo years of experience supervising staffExperience working at Pre-Paid Inpatient Health Plan (PIHP), Community Mental Health (CMH) or SUD provider agencyExperience in writing reports, analyzing data and administrative projectsAbility to be a “work leader” (of a person or function), or advise othersExperience in managing projects and teamsExcellent organizational and writing skillsDemonstrated knowledge of Microsoft Word and ExcelAbility to exercise some flexibility in problem solving, when expected results are clear and generally set by others, provided certain outcomes are avoidedIngenuity is required to adapt, alter, or improvise alternatives when unexpected situations occurAbility to exercise discretion and some flexibility in selecting an optimal solution from established alternatives to obtain the desired outcomeAbility to use or exert influence in a work processAbility to provide, exchange or explain information which conveys an opinion or evaluation of the facts or analysesAbility to develop and/or maintain effective work relationships with new, established, or non-receptive individuals/organizations through tact, diplomacy, and persuasionBasic knowledge of MDHHS reportingBasic knowledge of State of Michigan Medicaid Provider ManualValid State of Michigan Driver’s LicenseMust have access to transportationPreferred QualificationsFive years of experience supervising staffFive years of experience working with a Pre-Paid Inpatient Health Plan (PIHP)Experience in privileging and credentialingExperience with Microsoft PowerPointAdvanced knowledge of MDHHS reportingAdvanced knowledge of State of Michigan Medicaid Provider ManualSummary
Region 10 is committed to being a premier employer by enhancing the lives of our team and supporting their growth as people and professionals. We provide competitive wage scales that reward experience and performance, ongoing career development and training opportunities, excellent health coverage, generous paid time off with additional performance-based incentives, 13 paid holidays, flexible scheduling, and a comprehensive benefit program.NOTICE TO APPLICANTS
When applying, be sure to include evidence that the minimum qualifications are met (resume, copy of license, copy of educational transcripts, description of years of experience, skill-based experience/training, letters of reference, etc.).This position will be hired as employment-at-will.Any offer of employment is contingent upon a Criminal Background Check, as well as a 5 Panel Drug Screen.Region 10 PIHP embraces an employment environment that promotes recovery and discovery, a person-centered approach to treatment/services, and cultural competence. An employee in this or any position is expected to support the employment environment.Region 10 PIHP provides equal employment opportunities (EEO) to applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Region 10 PIHP complies with applicable state and local laws governing nondiscrimination in employment.
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