Campus Pride Jobs

Employment Type:

Full time

Shift:

Day Shift

Description:

Why MediGold?

MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare beneficiaries across the United States. We’re dedicated to providing excellent customer service, cost-effective care, and exceptional healthcare coverage. We rely on talented colleagues in a wide variety of professional roles including information technology, financial analysis, audit, provider relations and more.

We know that exceptional patient care starts with taking care of our colleagues, so we invest in great people and all that we ask in return is that you come to work ready to make a difference and do the right thing.

What we offer:

• Competitive compensation and benefits packages including medical, dental, and vision coverage

• Retirement savings account with employer match starting on day one

• Generous paid time off programs

• Employee recognition incentive program

• Tuition/professional development reimbursement

• Relocation assistance (geographic restrictions apply)

• Discounted tuition and enrollment opportunities at the Mount Carmel College of Nursing

Why Columbus?

The nation's 14th largest city, Columbus, Ohio is one of the fastest growing major metropolitan areas in the Midwest – ranked #1 for population growth, #1 for job growth, #1 for wage growth, and #1 real estate market. And with a vibrant blend of professional sports, world-class attractions, creative cuisines, and a flourishing music and arts scene, you'll never be found wanting for entertainment and experiences to call your own in Columbus. Learn more at www.experiencecolumbus.com !

About the job:

Market Manager - Provider Relations and Network Development is responsible for the strategic oversight of a geographic area or market of Provider Relations Managers. The Market Manager Provider Relations and Network Development will maintain a portfolio of provider relations work within the area or market (including contracting, recruitment, provider retention and strategy development) along with ensuring area or market level targets are aligned with organizational objectives. The Market Manager-Provider Relations and Network Development may also manage a team/function within the broader Network Management arena.

What you'll do:

Responsible for supporting Clinically Integrated Networks (CIN) and networks across broad regions with focus on system wide contracting opportunites.

· Develop and implement a network development plan for multiple regions.

· Work with senior leadership to design, develop and implement value based programs (APM)

that meet and reward quality and meet the goals of triple AIM.

· Manage and support staff across an area/market to ensure departmental and company wide goals are met.

· Responsible for supporting the CIN governance structure to ensure actions for the board are executed upon a timely and reportable fashion.

· Leads expansion opportunities into new states to ensure CMS adequacy and product salability by leveraging Quest Analytics and Zelis (or related tool) to benchmark against competitors.

· Supports applicable CIN committee by providing network adequacy, capacity, and participation information and developing strategies related to filling gaps and growing the network.

· Manages the relationship with Trinity/Mount Carmel ministries to ensure alignment of enterprise goals of triple AIM. Participates in leadership meetings at the MediGold and enterprise level as needed.

· Enhance the engagement and partnership between the plan and its provider partners through effective leadership of the Joint Operating Committees (JOC)

· Manages staff relations including performance management, staff satisfaction, and conflict management. Performs and oversees scheduling, recruitment, payroll, and student engagements

· Monitors departmental budgets, regulatory compliance, departmental contracts, and vendor relations

· Responsible for the daily activities of the provider network staff, which may include network development, contracting, credentialing, provider relations, and provider services

What we're looking for:

Education: Bachelor’s Degree in business administration, finance, health administration or similar field preferred

· Licensure / Certification: None

· Experience: 5 or more years of relevant work experience in health plan provider relations including experience in leadership roles

· Effective Communication Skills

· Ability to supervise, lead and motivate colleagues in a team-building collaborative atmosphere.

· Demonstrated ability to influence and create solutions when complex issues arise

· Demonstrated ability to identify areas of opportunity within Provider networks for improving

· overall efficiency and quality

· Working knowledge of protocols and procedures of Centers For Medicare and Medicaid

· Services

· Proven ability to work effectively with internal and external multi-disciplinary teams and key internal/external stakeholders across

· Proven track record of managing multiple priorities and executing tasks within tight

· timeframes

· Experience in identifying and executing process improvement needs

· Effective Communication Skills

· Must possess a high degree of motivation, initiative, and organizational ability

· Valid driver's license

· Requires use of a personal vehicle with valid auto insurance.

Our Commitment to Diversity and Inclusion

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

EOE including disability/veteran