Welcome to Arkos Health! We are a value-based healthcare company providing solutions for payors and providers by combining unique technology with in-home, virtual, and in-clinical care for patients. Arkos serves health plans and provider organizations by managing their highest-risk and highest-cost populations. We are currently in Arizona, Nevada, North Dakota, Illinois and Vermont! Our goal is to be the most valued partner to health plans, service providers, and the community we collectively serve.

We are looking for a Provider Relations Manager to join our team!

How You'll Make a Difference:

The Provider Engagement Manager (PEM) assists in the overall success of the department. This position supervises a team comprised of Provider Engagement Representatives and Coordinators. The PEM plays a critical role in ensuring high levels of provider satisfaction and will possess excellent relationship building and leadership skills.

Why Arkos?

• Great Benefits!
  • Employer-paid Medical, Dental and vision premiums at no cost to you
  • Employer-paid Short-Term Disability premiums at no cost to you
  • Employer-paid Life Insurance premiums at no cost to you
  • Employer matching 401(k)
  • 15 days annual combined sick/vacation and 9 days of holiday during your first year
  • Your Birthday off!

• We have great people and a growing culture! From coffee bars to Ice Cream Day, we recognize our team!
• We are ranked as the 113th fastest-growing private company in the United States and 11th within the healthcare services sector on the 2024 Inc. 5000 list! Join us today!

Essential Duties and Responsibilities:

• Manages all aspects of Provider Engagement, acting as a player and coach, to include provider relationships and operations to support provider service, provider education, and product and market expansions.
• Manages Provider Engagement staff in the day-to-day performance of their jobs
• Provides weekly metrics to Market Leadership regarding departmental performance
• Monitors and drives management of the team and performance through analytics, processes and tools to ensure departmental goals are being met
• Develops and trains staff to educate key individuals in provider groups regarding new approaches, products, reimbursement methodologies, appropriate coding including risk scores, quality measures and policy standards changes
• Monitors the effectiveness and timeliness of provider communication, education, and resolution of provider concerns:
  • Ensures assigned provider offices have frequent and regular interactions with the Provider Relations team
  • Tracks and reports on office visit activity by the Provider Relations team
  • Identifies provider issues and follows to resolution
    • Coordinates and tracks timely responses for provider issues involving referrals, prior authorizations, claims and credentialing issues in collaboration with the health plan; escalates issues to supervisor requiring immediate intervention
• Conducts periodic office surveys on effectiveness of provider communications
• Assists the Market Leadership on partnering with the Education Group to conduct effective practice management programs and educational events
• Assists the Director of Provider Relations with internal and health plan Marketing/Sales department with provider-specific marketing initiatives
• In conjunction with the Market Leadership develops and implements departmental policies and procedures. Reviews and updates departmental policies and procedures annually at minimum, and as needed
• Identify staff failing to meet goals and expectations and create performance improvement action plans
• Monitor and maintain monthly calendar for visitation for all Provider Engagement Representatives to ensure consistent provider engagement
  
• Assists with development, implementation, and management of community outreach strategy with network providers including a communication plan to keep them informed of current issues
• Supports the Provider Engagement Representatives in managing strong working relationships with all providers; this includes in-office visits and out-of-office meetings with provider groups as needed
  

Qualifications and Skills:

• Associates degree or relevant equivalent experience
• Prior experience with provider networks and contracting with physicians
• Preferred knowledge of CPT, ICD, HCPCS, HCC coding and STARS?HEDIS measures; training may be available for the right candidate
• Demonstrated experience to interact professionally with healthcare professionals
• Current unrestricted Georgia Driver’s license, reliable transportation and proof of insurance required
• Knowledge of HMO, PPO, Medicare Risk and Indemnity products preferred; Accuracy and detail orientation (written and verbal)
  
  

What's Next?

Apply for the Job! Our recruitment team will review your application and reach out to schedule a quick call!

Please feel free to forward this opportunity to someone you believe might be a good fit! If hired, you could be eligible for a referral bonus!

Must complete our Culture Index Survey. Take the assessment at https://go.cultureindex.com/s/bg3VS0H2kF. This is not a pass/fail test and does not measure intelligence.

Arkos Health EEO Statement:

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.

Arkos Health is a drug-free workplace. All job applicants selected for employment are required to submit to a pre-employment drug test and background check.

Arkos Health participates in E-Verify to confirm eligibility to work in the United States. To view the details on this program, visit our career page at Careers - Arkos Health