Manager, Provider Network Solutions Operations

This job was posted by https://www.kansasworks.com : For more

information, please see: https://www.kansasworks.com/jobs/13428844 Under

the direction of the Director, Provider Network Solutions Operations,

position is responsible for divisional operations activities for the

BCBSKS provider networks including enrollment, procedural and record

quality initiatives, record maintenance, and provider communications.

Designs, implements and monitors procedures to ensure smooth, accurate

and timely workflow within the department and works collaboratively

across BCBSKS to ensure provider network processes and activities are

transparent, and adhere to internal and external audit and compliance

requirements. Manage the work of Provider Network Solutions team members

ensuring onboarding and network maintenance activities frame a

compliant, quality driven provider network to strengthen BCBSKS provider

experience and member\'s access to our provider network. Provide timely

education to department team members. Manage department activities in

support of meeting corporate goals and objectives. Ensures the accuracy

and timeliness of provider data for directory purposes.

\*\* This position is eligible to work hybrid (9 or more days a month

onsite) in accordance with our Telecommuting Policy. Applicants must

reside in Kansas or Missouri or be willing to relocate as a condition of

employment.

• Are you ready to make a difference? Choose to work for one of the most
  
  

trusted companies in Kansas.**

• Why Join Us?**
• **Lead and Inspire:** Guide and mentor your team to achieve their
  
  

full potential and success.

• **Family** **Comes First**: Total rewards package that promotes the
  
  

idea of family first for all employees.

• **Dynamic Work Environment:** Collaborate with a team of passionate
  
  

and driven individuals.

• **Trust:** Work for one of the most trusted companies in Kansas
• **Stability:** 80 years of commitment, compassion and community
  
  

**Compensation**

**116,000 - \$145,000**

Exempt grade 18

• Blue Cross and Blue Shield of Kansas offers excellent competitive
  
  

compensation with the goal of retaining and growing talented team

members. The salary range for this role is a good faith estimate, it

is estimated based on what a successful candidate might be paid. All

offers presented to candidates are carefully reviewed to ensure

fair, equitable pay by offering competitive salaries that align with

the individual\'s skills, education, experience, and training. The

range may vary above or below the stated amounts.

**What you\'ll do**

• Directs the coordination of activities related to provider
  
  

contracting and network enrollment. Includes workflow review and

assignment, network onboarding activities including contract

initiation, record creation and maintenance.

• Establishes goals and objectives supporting the management and
  
  

supervision the daily activities of the department ensuring

alignment with corporate goals and objectives.

• Collaborates with other departments/divisions to attain accurate and
  
  

up-to-date information for provider network framework requirements,

expectations, adequacy, adherence, and experience.

• Responsible for the coordination and general direction of provider
  
  

network communications to include contracting documents, provider

memos, policy updates, network initiatives, etc.

• Identifies problems and designs/recommends team member success needs
  
  

through guidance and coaching.

• Ensure compliance of all requirements by law for establishing new
  
  

provider data, as well as maintenance, and storage.

• Identifies, designs, and implements appropriate solutions to
  
  

staffing, quality and workload problems in a timely and effective

manner. Interview, hire, and discipline.

• Provides appropriate and timely performance feedback to staff both
  
  

formally and informally. Reviews and recommends merit and promotion

increases.

• Anticipates the impact of the changing healthcare environment on
  
  

assigned work areas and adjusts work assignments and processes as

necessary to maintain quality and efficient workflow within the

department.

• Manages assigned projects meeting deadlines and assuring results
  
  

meet the business need of the organization.

• Responsible for the creation, updates, and publishing of all
  
  

Provider Network Solutions policies and procedures for both internal

transparency and guidance and external accreditation compliance

standards.

• Direct oversight of Supervisor, Provider Network Enrollment and
  
  

Supervisor, Provider Network Records and Quality. Indirect

supervision of assigned team members to each supervisor.

**Knowledge/Skills/Abilities**

Excellent organizational and administrative application skills

Advanced supervisory history demonstrative of coaching success, design

of goals and human relations

Excellent Written and Verbal Communications

Broad knowledge of health industry as it relates to professional and

institution provider operations

Independent problem solving and analytical skills

Leadership skills focused on strategic revie