Manager, Network Relations

The Manager, Network Relations will serve as the primary resource for an assigned profile of large provider groups/health systems to establish, oversee, and maintain provider risk management and positive relationships. This role drives the implementation of internal and external solutions to achieve provider satisfaction, cost targets, network growth, and efficiency targets. Responsibilities include optimizing interactions with assigned providers and internal business partners, managing provider servicing matters, and collaborating cross-functionally to ensure constituent needs are met by driving resolutions for escalated issues related to claims payment, policies, accuracy of provider demographic information, and contract interpretation. The position involves educating providers on contract parameters, plan design, compensation processes, technology, policies, and procedures. Additionally, the role manages the development of agendas, validates materials, and facilitates external provider meetings to ensure service levels meet expectations. Collaboration with cross-functional teams to manage cost drivers, execute cost initiatives, and identify trends for problem resolution is also part of the duties.