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DIRECTOR OF PROVIDER RELATIONS

Company: The State of New Hampshire
Location: Concord
Posted on: February 24, 2021

Job Description:

For assistance contact the State of New Hampshire - Division of Personnel
Monday through Friday 8:00 AM - 4:00 PM EST (603) 271-3261 or nhjobs@das.nh.gov Search Result for: Recent Job Listings All Job Listings Recent - Featured Jobs - All
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We'll email you new jobs that match this search Back to Job Listing DIRECTOR OF PROVIDER RELATIONS #9U390 (Job ID: 19394) State of New Hampshire Job Posting Department of Health and Human Services Division of Medicaid Services Concord, NH PROVIDER RELATIONS MANAGER LG EE #9U390 $67,245.36-$93,654.60 USD *See total compensation information at the bottom of announcement. The State of New Hampshire,--Department of Health and Human Services, Division of Medicaid Services--has a full time vacancy for Provider Relations Manager. SUMMARY:
Oversees and manages an extensive array of interactions with all provider types related to Fee for Service and Managed Care in the Department of Health and Human Services (DHHS). Directs and implements strategies for the development and management of provider networks through ongoing engagement and feedback between providers and the NH Medicaid program. Serves as the primary provider liaison in contract and operational matters concerning the provider network. Serves as Medicaid's representative to various provider organizations. Oversees collaboration and provider relations activities and obligations for the State's three Managed Care Organizations. RESPONSIBILITIES:
Develops and implements strategies to build, support, and ensure retention of the Fee for Service Provider Network. Identifies disparities in service provider types in the network and develops and implements strategies to address those disparities.-- Serves as the DHHS representative on provider related initiatives. Provider types include, but are not limited to: hospitals, clinics, community health centers, community mental health centers, physicians, ancillary service providers, rehabilitation service providers, pharmacy providers, diagnostic service providers, long term care, community supports and service providers, behavioral health providers, and substance abuse providers, and transportation providers. Coordinates relevant internal stakeholders such as the policy and finance teams and subject matter experts, and the fiscal agent for the creation and distribution of provider communications.-- Assists with the development, design and implementation of Managed Care Provider Network, communication strategies, inclusive of web-based communications and websites, and maintains records relative to communications to ensure mutual understanding. Acts as single point of contact for Non-Emergency Medical Transportation (NEMT) broker, ensuring compliance with federal regulation, consults on network adequacy, and resolves member and provider concerns.-- Serves as a liaison and primary point of contact to providers in the management, review, and resolution of provider inquiries and provider grievances which remain unresolved after fiscal agent intervention. Supervises staff responsible for the day-to-day operation of managing and resolving provider grievances. Advises and assists providers in understanding NH Medicaid protocols, policies, procedures and other state and federal regulatory requirements. Collaborates with DHHS Medicaid Managed Care Operations staff to ensure effective and consistent messaging across Fee for Service and Managed Care providers. Coordinates activities with the Medicaid contracted fiscal agent's Provider Relations unit and ensures contractor engagement in provider network activities as defined by the contract. Maintains and adapts departmental operations, initiatives, and priorities to address provider sensitive business and operational needs. Assists in the planning and facilitation of in-person, telephonic, and on-line education sessions, meetings and communication sessions with providers.-- Acts as Medicaid's representative to various provider organizations including but not limited to: provider associations, management groups, and professional societies. Serves on external committees and workgroups representing the NH Medicaid program as assigned.-- Oversees the enrollment of low risk providers, including the supervision of DHHS staff member responsible for the day-to-day operation of approving enrollments. Assists in the negotiating, reviewing and design of enrollment agreements
EDUCATION and EXPERIENCE: Master's Degree in Business, Communications, Public Administration, or Health Care field. Qualified candidates should possess understanding of health insurance claims, strong ability to analyze data and resolve provider insurance related issues. LICENSE/CERTIFICATION: None.-- SPECIAL REQUIREMENTS: Excellent verbal and written communication skills. Working knowledge of health care services delivery, provider networks and provider organizations. Working knowledge of contracts, data and analysis, quality improvement. Previous experience with Medicaid and/or other public payer programs is required. DISCLAIMER STATEMENT: The supplemental job description lists typical examples of work and is not intended to include every job duty and responsibility specific to a position. Any employee may be required to perform other related duties not listed on the supplemental job description provided that such duties are characteristic of that classification.
-- For further information please contact Alyssa Cohen, Deputy Medicaid Director, Alyssa.Cohen@DHHS.NH.GOV , 603-271-9691. Documents that can't be submitted online may be forwarded to: Department of Health and Human Services- Human Resources 129 Pleasant Street Concord, NH 03301 *TOTAL COMPENSATION INFORMATION The State of NH total compensation package features an outstanding set of employee benefits, including: HMO or POS Medical and Prescription Drug Benefits: The actual value of State-paid health benefits is based on the employee--s union status, and employee per pay period health benefit contributions will vary depending on the type of plan selected. See this link for details on State-paid health benefits: https://das.nh.gov/hr/benefits.html Value of State's share of Employee's Retirement: 11.93% of pay Other Benefits: o Dental Plan at minimal cost for employees and their families ($500-$1800 value) o Flexible Spending healthcare and childcare reimbursement accounts o State defined benefit retirement plan and Deferred Compensation 457(b) plan o Work/life balance flexible schedules, paid holidays and generous leave plan o $50,000 state-paid life insurance plus additional low cost group life insurance o Incentive-based Wellness Program (ability to earn up to $500) Total Compensation Statement Worksheet: https://das.nh.gov/documents/hr/JobSearch/FINAL_TOTAL_COMP_STATEMENT_ISSUE.xlsx Want the specifics? Explore the Benefits of State Employment on our website: https://das.nh.gov/hr/documents/BenefitBrochure.pdf https://das.nh.gov/hr/index.aspx EOE TDD Access: Relay NH 1-800-735-2964 Back to Job Listing Job Summary
Position DIRECTOR OF PROVIDER RELATIONS #9U390 Category OTHER Employment Type Post Date 01/22/2021 Salary USD 67,245.360-93,654.600 Close Date Location US:NH:CONCORD
Invalid Address 129 PLEASANT STREET,SOP SO-BRWN BLDG 4TH FLOOR,MERRIMACK,CONCORD,NH,03301,US Note : You can add more than one Email Address in 'To' field separated by comma(,)
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DIRECTOR OF PROVIDER RELATIONS #9U390 (Job ID: 19394) State of New Hampshire Job Posting Department of Health and Human Services Division of Medicaid Services Concord, NH PROVIDER RELATIONS MANAGER LG EE #9U390 $67,245.36-$93,654.60 USD *See total compensation information at the bottom of announcement. The State of New Hampshire,--Department of Health and Human Services, Division of Medicaid Services--has a full time vacancy for Provider Relations Manager. SUMMARY:
Oversees and manages an extensive array of interactions with all provider types related to Fee for Service and Managed Care in the Department of Health and Human Services (DHHS). Directs and implements strategies for the development and management of provider networks through ongoing engagement and feedback between providers and the NH Medicaid program. Serves as the primary provider liaison in contract and operational matters concerning the provider network. Serves as Medicaid's representative to various provider organizations. Oversees collaboration and provider relations activities and obligations for the State's three Managed Care Organizations. RESPONSIBILITIES:
Develops and implements strategies to build, support, and ensure retention of the Fee for Service Provider Network. Identifies disparities in service provider types in the network and develops and implements strategies to address those disparities.-- Serves as the DHHS representative on provider related initiatives. Provider types include, but are not limited to: hospitals, clinics, community health centers, community mental health centers, physicians, ancillary service providers, rehabilitation service providers, pharmacy providers, diagnostic service providers, long term care, community supports and service providers, behavioral health providers, and substance abuse providers, and transportation providers. Coordinates relevant internal stakeholders such as the policy and finance teams and subject matter experts, and the fiscal agent for the creation and distribution of provider communications.-- Assists with the development, design and implementation of Managed Care Provider Network, communication strategies, inclusive of web-based communications and websites, and maintains records relative to communications to ensure mutual understanding. Acts as single point of contact for Non-Emergency Medical Transportation (NEMT) broker, ensuring compliance with federal regulation, consults on network adequacy, and resolves member and provider concerns.-- Serves as a liaison and primary point of contact to providers in the management, review, and resolution of provider inquiries and provider grievances which remain unresolved after fiscal agent intervention. Supervises staff responsible for the day-to-day operation of managing and resolving provider grievances. Advises and assists providers in understanding NH Medicaid protocols, policies, procedures and other state and federal regulatory requirements. Collaborates with DHHS Medicaid Managed Care Operations staff to ensure effective and consistent messaging across Fee for Service and Managed Care providers. Coordinates activities with the Medicaid contracted fiscal agent's Provider Relations unit and ensures contractor engagement in provider network activities as defined by the contract. Maintains and adapts departmental operations, initiatives, and priorities to address provider sensitive business and operational needs. Assists in the planning and facilitation of in-person, telephonic, and on-line education sessions, meetings and communication sessions with providers.-- Acts as Medicaid's representative to various provider organizations including but not limited to: provider associations, management groups, and professional societies. Serves on external committees and workgroups representing the NH Medicaid program as assigned.-- Oversees the enrollment of low risk providers, including the supervision of DHHS staff member responsible for the day-to-day operation of approving enrollments. Assists in the negotiating, reviewing and design of enrollment agreements
EDUCATION and EXPERIENCE: Master's Degree in Business, Communications, Public Administration, or Health Care field. Qualified candidates should possess understanding of health insurance claims, strong ability to analyze data and resolve provider insurance related issues. LICENSE/CERTIFICATION: None.-- SPECIAL REQUIREMENTS: Excellent verbal and written communication skills. Working knowledge of health care services delivery, provider networks and provider organizations. Working knowledge of contracts, data and analysis, quality improvement. Previous experience with Medicaid and/or other public payer programs is required. DISCLAIMER STATEMENT: The supplemental job description lists typical examples of work and is not intended to include every job duty and responsibility specific to a position. Any employee may be required to perform other related duties not listed on the supplemental job description provided that such duties are characteristic of that classification.
-- For further information please contact Alyssa Cohen, Deputy Medicaid Director, Alyssa.Cohen@DHHS.NH.GOV , 603-271-9691. Documents that can't be submitted online may be forwarded to: Department of Health and Human Services- Human Resources 129 Pleasant Street Concord, NH 03301 *TOTAL COMPENSATION INFORMATION The State of NH total compensation package features an outstanding set of employee benefits, including: HMO or POS Medical and Prescription Drug Benefits: The actual value of State-paid health benefits is based on the employee--s union status, and employee per pay period health benefit contributions will vary depending on the type of plan selected. See this link for details on State-paid health benefits: https://das.nh.gov/hr/benefits.html Value of State's share of Employee's Retirement: 11.93% of pay Other Benefits: o Dental Plan at minimal cost for employees and their families ($500-$1800 value) o Flexible Spending healthcare and childcare reimbursement accounts o State defined benefit retirement plan and Deferred Compensation 457(b) plan o Work/life balance flexible schedules, paid holidays and generous leave plan o $50,000 state-paid life insurance plus additional low cost group life insurance o Incentive-based Wellness Program (ability to earn up to $500) Total Compensation Statement Worksheet: https://das.nh.gov/documents/hr/JobSearch/FINAL_TOTAL_COMP_STATEMENT_ISSUE.xlsx Want the specifics? Explore the Benefits of State Employment on our website: https://das.nh.gov/hr/documents/BenefitBrochure.pdf https://das.nh.gov/hr/index.aspx EOE TDD Access: Relay NH 1-800-735-2964
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