Blue Cross of Idaho has an exciting opportunity for a Manager, Provider Operations. This role will lead and have oversight of the processes targeted at defining, establishing, and operationalizing provider services, while following regulatory standards, collaborate with various departments to improve processes, build performance metrics, and support leadership in planning for current and future needs.
We are looking for a candidate with:
Experience: 7 years provider experience, (either in provider offices or with health plans) to ensure a robust knowledge of the day-to-day operations in a provider office. Experience must include leadership and project management with technical knowledge of business office functions.
Education: Bachelor's Degree or equivalent work experience (Two years' relevant work experience is equivalent to one-year college)
What a day of a Manager would look like:
Oversees day-to-day operations, staffing, and performance management to ensure departmental milestones and goals are met.
Builds and maintains effective relationships and processes with our healthcare providers.
Internally advocates for our providers by driving our Information Technology (IT) priorities to align with the needs and expectations of the provider community.
Develops operational plans to address shortfalls or future state needs with the goal of continual process improvement.
Bridges the gap between business requirements and technical solutions with an emphasis on automation, innovation, and simplification.
Tracks and monitors department and cross-departmental projects. Plans and guides future projects collaborating with other leaders in the organization to drive results.
Manages all aspects of essential vendor contracts that support provider experience
Develops, interprets, and provides training to the provider relations team on policies, procedures, service standards, scripting, and workflows to support the application of practices across our department and other functional areas, such as Customer Service and Grievances and Appeals.
Ensures department policies and practices meet all compliance requirements and regulations.
In collaboration with senior leadership, designs, develops, and implements focused functional area strategies.
Performs other duties and responsibilities as assigned.
Reasonable accommodations
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.
