Provider Network Manager - Orange County

Job Description

Job Description

About us:

Solis Health Plans is a new kind of Medicare Advantage Company. We provide solutions that are more transparent, connected, and effective for both our members and providers. Solis was born out of a desire to provide a more personal experience throughout all levels of the healthcare journey. Our team consists of expert individuals that take pride in delivering quality service. We believe in a culture that collaborates and supports one another, and where success is interlinked, and each employee is valued. Please check out our company website at to learn more about us!

*Candidates must be local to Orange County*

**BILINGUAL - ENGLISH & SPANISH IS REQUIRED**

PROVIDER NETWORK MANAGER

POSITION SUMMARY:

The Provider Network Manager is responsible for developing and retaining business and providing excellent service to clients in the specified geographic region. The ideal person will have proven experience building on existing relationships, eliminating competitive threats within our network base, and ensuring satisfaction within our accounts.

ESSENTIAL DUTIES AND RESPONSIBILTIES:

• Generates and develops new business to meet specified production goals.

• Maintains and nurtures existing client relationships.

• Responds to all inquiries and requests in a timely and professional manner.

• Functions as liaison between client companies and operations staff.

• Understands and communicates information regarding company products, services, and policies and procedures to new and existing clients.

• Possesses and maintains thorough knowledge of Medicare Advantage Plan product information.

• Continually gathers information on local competition and prevalent industry and business climate within the region; communicates information to management and others as needed.

• Works with more complex providers. Complex providers may include, but are not limited to large institutional providers, and large medical groups, value-based concepts understanding and support, providers in areas with strong competition or where greater provider education around managed care concepts is required.

• Conducts more complex negotiations and drafts documents.

• Ensures that all required client paperwork is complete, accurate, and submitted on time.

• Provides timely and accurate reports as required.

• Strong background in value based/full risk PCP MSO/IPA arrangements related to Medicare Advantage and other governmental programs.

• Attends and participates in business/trade events that impact business unit.

• Attends and participates in team strategic sales meetings.

• Performs other related duties as assigned by management.

QUALIFICATIONS & EDUCATION :

• Bachelor's degree (B. A.) or equivalent, 6 years of experience, or equivalent combination of education and experience.

• 5 years of experience in value based contract agreement (care).

• Bilingual in Spanish preferred

• 5 years Medicare Advantage Plan.

• Provider Network experience.

• Must be a self-starter and proactive.

• Commitment to excellence and high standards.

• Excellent written and verbal communication skills.

• Good judgement with the ability to make timely and sound decisions.

• Creative, flexible, and innovative team player.

• Demonstrated ability to make successful presentations to individuals and/or groups at all levels of an organization.

• Strong organizational skills; able to manage priorities and workflow.

• Ability to work independently and as a member of various teams and committees.

• Ability to calculate figures and amounts such as discounts, interest, commissions, and percentages.

• Excellent problem resolution and consultative sales skills.

• Proven ability to handle multiple projects and meet deadlines

• Strong interpersonal skills.

• Ability to prepare reports and business correspondence.

• Versatility, flexibility, and a willingness to work within constantly changing priorities with enthusiasm.

What set us apart:

Join Solis Health Plans as a Provider Network Manager and become a catalyst for positive change in the lives of our members. At Solis, you will be part of a locally rooted organization deeply committed to understanding and serving our communities. If you are eager to embark on a purpose-driven career that promises growth and the chance to make a significant impact, we encourage you to explore the opportunities available at Solis Health Plans. Join us and be the difference!

JOIN OUR RAPIDLY GROWING TEAM! Our company has doubled in size , and we've grown our membership from 2,000 to over 10,000 members —and we're just getting started!

Benefits include (starting the first of the month following your hire date):

• Medical, Dental, and Vision Insurance

• 401(k) plan with 100% company match

Be part of something big. Join our winning Solis Team today!