Manager-Provider Network Management
Agency Name: Region 10 PIHP
Agency Contact: HR
- Position Type: Full Time
- Job Type: Permanent
- County: St. Clair
- Salary Range: 61,200 per Year
- Send applications to: https://Secure.YourPayrollHR.com/ta/TPC0161.careers?ShowJob=637794382
- Please include your resume when applying.
$1500 Sign-On Bonus available
Region 10 is committed to being a premier employer by enhancing the lives of our team and supporting their growth as people and professionals. $1500 sign-on bonus available. We provide competitive wage scales that reward experience and performance, ongoing career development and training opportunities, excellent health coverage, generous paid time off with additional performance-based incentives, 13 paid holidays, flexible scheduling, and a comprehensive benefit program.
ESSENTIAL FUNCTIONS
The Manager-PNM is an administrative position with responsibility in providing direction for provider network management activities for the provider organizations that deliver public behavioral health services in the counties of Genesee, Lapeer, Sanilac, and St. Clair and their contract agencies.
• Provide training, guidance, and support to the Network Management Team and Network Providers.
• Chair the PIHP Provider Network Committee and Privileging & Credentialing Committee.
• Member of the Quality Improvement Committee.
• Review Privileging and Credentialing initial and renewal applications and manage process for tracking, notifications, and updates.
• Provide support for external audits including reviewing document submissions, providing presentations, and developing recommendations on Corrective Action Plans.
• Manage provider contracts.
• Oversee Policy and Procedure development and ongoing review.
• Manage Medicaid bulletin and proposed policy reviews.
• Oversee process for monitoring provider service contracts.
• Manage procurement activities including requests for proposals.
• Supervision of Provider Network Management staff.
MINIMUM QUALIFICATIONS
• Master’s Degree in behavioral health or related field
• Experience in the area of Contracts or Provider Network Management
• Two years of experience supervising staff
• Experience working at Pre-Paid Inpatient Health Plan (PIHP), Community Mental Health (CMH) or SUD provider agency
• Experience in writing reports, analyzing data and administrative projects
• Experience in managing projects and teams
• Basic knowledge of MDHHS reporting
• Basic knowledge of State of Michigan Medicaid Provider Manual
PREFERRED QUALIFICATIONS
• Five years of experience supervising staff
• Five years of experience working with a Pre-Paid Inpatient Health Plan (PIHP)
• Experience in privileging and credentialing
• Advanced knowledge of MDHHS reporting
• Advanced knowledge of State of Michigan Medicaid Provider Manual
NOTICE TO APPLICANTS
• When applying, be sure to include evidence that the minimum qualifications are met (resume, copy of license, copy of educational transcripts, description of years of experience, skill-based experience/training, letters of reference, etc.).
• This position will be hired as employment-at-will.
• Any offer of employment is contingent upon a Criminal Background Check, as well as a 5 Panel Drug Screen.
• Region 10 PIHP embraces an employment environment that promotes recovery and discovery, a person-centered approach to treatment/services, and cultural competence. An employee in this or any position is expected to support the employment environment.
• Region 10 PIHP provides equal employment opportunities (EEO) to applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Region 10 PIHP complies with applicable state and local laws governing nondiscrimination in employment.