Manager, Provider Network Management Alaska Operations (Finance)

We offer remote work opportunities (AK, AR, AZ, CA, *CO, FL, *HI, IA, ID, *IL, KS, LA, MD, *MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, *WA, WI & WY only).

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Veterans, Reservists, Guardsmen and military family members are encouraged to apply!

Job Summary

In partnership with the VP, Alaska Operations, the Manager, Provider Network Mgmt, is responsible for supporting customer satisfaction for stakeholders of TriWest's provider network to include: supervision of the provider relations specialist and collaboration with direct contract managers to ensure that Alaska Operations is meeting established goals and performance metrics; processing of provider contract, demographic, and reimbursement information; research and resolution of provider complaints and/or contract requests through leading teams; oversight of initial contract request process from interested network providers. Monitors quality indicators, dashboard metrics, and operational/data analysis. The Manager is also responsible for the achievement, motivation, and training of Alaska Operations staff supporting the VA CCN and TRICARE T-5 contract execution.

Education & Experience

Required:

• Bachelor's (BS/BA) Degree and three (3) years of varied and responsible experience with health care programs, or any combination of education and experience that provides an equivalent background
• Minimum of three (3) years supervisory/management experience
• U.S. Citizen
• Must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation
• Three years or more of experience in provider relations or data, contracting support or healthcare operations
• Excellent written and verbal communication skills

Preferred:

• Experience in managing workflow and workload and performance tracking and reporting

Key Responsibilities

• Assist VP, Alaska Operations with managing goals and staff development to promote high levels of customer satisfaction and efficiency and streamline processes.
• Demonstrate and maintain current knowledge of all VA and TRICARE programs, contracting, credentialing, reimbursement and operational policies and participate in all required training. Maintain current knowledge of TriWest initiatives, operations, and goals.
• Collaborate closely with other department leadership, staff, and leadership/staff in other TriWest departments on process improvement and service level improvements.
• Direct staff to resolve complaints and grievances tied to the provider network. Oversee coordination of processes, staff and reporting to support contractual response times. Engage in escalated media or congressional issues as needed.

• Coordinates interested provider contracting requests, including: managing department workflow and workload; developing and tracking provider contract and reports; managing the provider recruitment dashboard used to notify TriWest of their compliance with established metrics; monitoring the entire provider network request process to identify anomalies or issues that should be addressed; and working with the Sr. Project Manager to funnel into network adequacy processes.
• Supervises daily operations and staff for all respective provider complaint support functions. This includes maintenance and annual review of the policies and procedures.
• Ensures Contract Support team performs all administrative contracting tasks assigned for interested providers, network subcontractors, and internal customers.
• Head or participate in various projects and committees assigned by VP, Alaska Operations, as well as other duties as assigned.

Competencies

Coaching / Training / Mentoring: Actively foster actions required for desired business outcomes through ongoing constructive feedback.

Commitment to Task: Ability to conform to established policies and procedures; exhibit high motivation.

Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapt to different styles; listen critically; collaborate.

Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.

Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required.

Creativity / Innovation: Ability to develop unique and novel solutions to problems; view change as necessary.

Delegation Skills: Provide clear performance expectations for projects and ensure adequate access to resources for completion.

Information Management: Ability to manage large amounts of complex information easily, communicate clearly, and draw sound conclusions.

High Intensity Environment: Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow.

Leadership: Successfully manage different styles of employees; provide clear direction and effective coaching.

Multi-Tasking / Time Management: Prioritize and manage actions to meet changing deadlines and requirements within a high volume, high stress environment.

Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.

Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues.

Team-Building / Team Player: Influence the actions and opinions of others in a positive direction and build group commitment.

Working Conditions

Working Conditions:

• Favorable working conditions in a climate controlled office space
• Must be able to travel (locally or distant with overnight stays) a minimum of ten (10) percent and maximum of thirty-five (35) percent of the time
• Must be able to lift a minimum of 20 lbs
• Must be able to work under stressful conditions
• Must be available to cover any work shift

Company Overview

Taking Care of Our Nation's Heroes.

It's Who We Are. It's What We Do.

Do you have a passion for serving those who served?

Join the TriWest Healthcare Alliance Team! We're On a Mission to Serve®!

Our job is to make sure that America's heroes get connected to health care in the community.

At TriWest Healthcare Alliance, we've proudly been on that important mission since 1996.

DoD Statement

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Benefits

We're more than just a health care company. We're passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:

• Medical, Dental and Vision Coverage
• Generous paid time off
• 401(k) Retirement Savings Plan (with matching)
• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
• Tuition reimbursement
• Paid volunteer time

*Annual base salary for Colorado, Hawaii, Illinois, Minnesota, Washington D.C. and Washington State residents: $89,000-$114,000 depending on experience*

Equal Employment Opportunity

TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that cultivates and supports diversity at every organizational level, including hiring and retaining a diverse workforce, and we highly encourages candidates from all backgrounds to apply. Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.