Provider Relations Manager

 SUPERIOR VISION SERVICES is a national managed vision care company with an unparalleled national network of diverse eye care providers. Our corporate office is in Rancho Cordova, California, adjacent to Sacramento, California. The company offers insured and self-funded PPO primary eye care plans to employers, government and other entities.  Superior Vision Services markets a variety of insured and discount plans in fifty states.  We seek employees who are creative-thinkers with fresh insights, who thrive in a dynamic, customer-centric environment. We value diversity and recognize that the unique qualities of individuals contribute to our strength. 

 





Job Relationship: Reports to Vice President of Provider Relations and Network Development



 



JOB SUMMARY:

 

The Provider Relations Manager is responsible for all aspects of provider contracting and relations activities related to the development and ongoing management of a variety of SVS product networks for a specific geographic area. The Provider Relations Manager is the primary contact for SVS and will build a knowledge base about the provider and client marketplace and business environment. Works with SVS Sales and related relationships, and may include clients and brokers.

 

MINIMUM QUALIFICATIONS:

 

  Education:  BA or BS in health care, business or related degree preferred.

 

  Experience:  3 years experience in managed health care, with a focus onprovider relations and contracting.Vision care provider network development preferred.

 

  Knowledge/Skills:

 

?  Excellent interpersonal and presentation skills

?  Understanding of Managed and Health Care industries

?  Timely and thorough problem resolution skills

?  Strong execution and follow-up skills

?  Team orientation and ability to work effectively across functional areas of the company

?  Well organized and resourceful

?  Ability to coordinate multiple tasks/projects

?  Strong and effective written and verbal skills

?  Strong and appropriate analytical and judgment skills

?  Ability to work independently, however follow agreed upon processes

?  Understanding of NCQA and QA initiatives related to provider contracting

?  Working knowledge of database programs such as Access and Excel, etc.

 

 

ACCOUNTABILITIES and REQUIREMENTS:

 

?  Negotiate provider agreements as required to successfully meet the needs of SVS members enrolled in a variety of SVS products and services.

?  Manage ongoing management of provider agreements and relationships with SVS.

?  Develop and provide appropriate network management and analysis reports.

?  Develop, Coordinate and Implement provider educational materials.

?  Facilitate the timely Credentialing and Re-Credentialing efforts of SVS providers.

?  Plan, coordinate and implement provider meetings as needed.

?  Provide support to Sales staff as needed to coordinate information and requests of potential, new or existing clients.

?  Participate with QA Committee related activities as needed.

?  Provide network activity and other business related reports as requested.

?  Occasional in state and out of state travel may be required.

?  Valid California driver license.

?  Credit card in good standing ( to secure rental car, hotel reservations, etc)

?  Understanding of unique provider contracting relationships and possible political considerations.

 

Interested applicants should send their resumes to Employment@superiorvision.com