Manager, Provider Relations
Company: McLaren Health Plan
Location: Flint
Posted on: May 15, 2022
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Job Description:
Mgr Provider Relations MI - (22003209)
McLaren Health Plan, a division of McLaren Health Care Corporation,
is a company with a culture of high performance and a mission to
help people live healthier and more satisfying lives. We are
looking for a Manager, Provider Relations to join in leading the
organization forward.McLaren Health Plan (MHP) is a Managed Care
Organization dedicated to meeting the health care needs of each
member. MHP and its subsidiaries offer multiple product lines,
including employer plans, individual and family plans, Medicaid and
Medicare plans, to Michigan residents for every stage of life. The
plan has earned the prestigious Pinnacle Award every year since
2013 from the Michigan Association of Health Plans and is also
accredited by the National Committee for Quality Assurance
(NCQA).With a commitment to diversity and inclusion, a strong focus
on improving the health of our members and a vision to provide the
highest standards of quality and service, MHP is poised to meet the
challenges of tomorrow.
Position Summary:Responsible for the planning, managing, and
organizing Provider Relations functions for all products as
designated. Responsible for developing a robust provider network,
in conjunction with senior staff, including negotiating and
contracting with providers. Responsibility for tracking and
managing Provider Relations activity, including staff and
performance reviews, provider education, and day-to-day operations
of the department. Professionally and effectively markets the
advantages of being a Plan network provider to prospective
providers. Generates new contracting opportunities through
telemarketing, written communications, and other distribution
channels. Develop and implement processes to monitor contractual
obligations and ensure the Plan's compliance with such. Maintains
regulatory compliance with State regulators and accrediting
agencies. Responsible for the identification, research, reporting,
and elimination of fraud and abuse. Responsible for analyzing,
development and implementation of education and training programs
for contracted providers and their staff. Designs, implements, and
adjusts workflows to ensure department efficiencies are
maintained.
Required:
Primary Location Michigan-Flint-McLaren Health Plan BldgWork
Locations McLaren Health Plan Bldg G3245 Beecher Rd Flint 48532Job
ManagerOrganization McLaren Health PlanEmployee Status RegularJob
Type StandardSchedule Full-timeShift Day JobOn Call NoWeekends
No
Keywords: McLaren Health Plan, Flint , Manager, Provider Relations, Executive , Flint, Michigan
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