Assistant Director, Provider Relations - Contracts Administration - The Health Plan

 
Position: Assistant Director, Provider Relations - Contracts Administration - The Health Plan

Job ID: 152183

Location: US-TX-Bellaire

Department: PROVIDER RELATIONS CENTRAL

Talent Area: Professional - Non-Clinical

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8a - 5p Monday - Friday

About Texas Children's Hospital

Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.   To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.  

Summary:

We are searching for an Assistant Director of Provider Relations — someone who works well in a fast-paced managed care setting. In this position, you will provide educational development to network providers through continuing medical educational offerings, performing strategic planning and partnering with academic research opportunities from the community on areas impacting child health, managed care, or women and family issues. You will provide supervision for Provider Relations staff responsible for the operational support needed to develop and maintain the network of hospitals, physicians and other healthcare providers who provide care to the members of our health plan.

 

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Responsibilities :

Job Duties & Responsibilities

HOU123

  • Serve as an internal and external liaison to resolve managed care issues, provider communications, and claims research to maintain positive relationships with providers
  • Participate in community and interdepartmental groups to represent academic partners, and continuing medical education
  • Serve as a liaison with community agencies and other groups and organizations which impact member health services
  • Maintain current knowledge and contact with alternate sites for appropriate health care delivery within the community and the state needed for member population
  • Develop management programs in response to analysis and research of managed care trends and benchmarks as well as the strategic goals of the health plan and the Integrated Delivery System
  • Support and develop programs aligned with health plan strategic goals through effective and timely assessments and equitable distribution of resources and assignments, and the education and implementation of processes and procedures that provide and maintain a cost-effective provider network


Qualifications:

Skills & Requirements

 

  • Bachelor’s degree in business, health care administration, public health, nursing or a related field
  • A minimum of 5 years’ experience in managed care experience in a managed care organization
  • A minimum of 2 years’ supervisory experience

 



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