Provider Relations Manager

BCforward is currently seeking a highly motivated Provider Relations Manager for an Onsite Opportunity at Tucson, AZ and Green Valley, AZ Position Title: Provider Relations Manager Location: Tucson, AZ and Green Valley, AZ Anticipated Start Date: ASAP Please note this is the target date, and it is subject to change. BCforward will send official notice ahead of a confirmed start date. Expected Duration: Full Time Job Type: Onsite Salary Range: $80,000/Yr.- $100,000/hr. Please note that actual compensation may vary within this range due to factors such as location, experience, and job responsibilities, and does not encompass additional non-standard compensation (e.g., benefits, paid time off, per diem, etc.). Job Summary: We are seeking a Network Support Manager to join our dynamic team. The ideal candidate will have strong experience in provider network operations, facility and provider contracting, value-based care, and quality programs and a proven ability to optimize network access, quality, compliance, and performance while driving operational execution and provider engagement . Responsibilities: Coordinate workflow and tactical implementation of activities to maintain facility and provider networks and contracting initiatives. Oversee day-to-day training, guidance, and management of department activities and resolve issues impacting facilities and providers. Analyze and coordinate strategies, policies, and programs to ensure accurate administration of facility and provider contracts across multiple lines of business and platforms. Create tools to assist with contract implementation and administration. Interface with providers on contractual obligations, education, and updates to provider operations manuals. Act as a business partner on projects ensuring accurate facility and provider reimbursement policies and procedures, including pricing, POC, OHAS HMO, OHAS II, complaints, and appeals. Participate in projects to improve network performance across multiple lines of business. Required Skills & Qualifications: Familiarity with Medicare Advantage, Medicaid Managed Care, and value-based care models. Understanding of CMS and state quality programs, risk adjustment, and utilization management. Competency with clinical and provider performance dashboards and EHR/workflow navigation. Experience with provider contracting language and operational requirements. Excellent communication and stakeholder management abilities. Requires a BA/BS degree and a minimum of 3 years of experience in the healthcare industry with background in provider relations, facility contracts, and reimbursement. An equivalent combination of education and experience will be considered. Preferred Skills: Experience managing multi-line provider networks and reimbursement policies and procedures. BCforward offers all eligible employees a comprehensive benefits package including, but not limited to: major medical HSA dental vision employer-provided group life voluntary life insurance short-term disability long-term disability 401k About BCforward: Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward’s 6,000 consultants support more than 225 clients globally. #J-18808-Ljbffr BCforward