Provider Relations Supervisor

Position Title: Provider Relations Supervisor
Department: Provider Relations
Title of Manager: Provider Relations Manager
Supervises: Provider Relations Specialists
Exemption Status: Exempt
Requisition ID: 20454

Job Summary
This position provides direct supervision for Provider Relations Specialists and triage provider related issues with Claims, Customer Experience, Clinical Operations departments, and other lines of business leaders. This position supports the Provider Relations Specialists in their role as primary provider contact for complex provider needs within CareOregon’s physical and behavioral health networks, as well as other networks CareOregon may support through administrative or management services agreements.

Education and/or Experience
Required:
Minimum 3 years of experience in provider relations, managed care operations, medical/behavioral clinic operations, or a related health care organization
Minimum 1 year experience in a supervisory or lead position; lead roles should include regular assistance to a manager or supervisor in employee hiring, coaching, performance evaluation, and other supervisory tasks
Valid driver’s license, acceptable driving record, and automobile liability coverage or access to an insured vehicle
Preferred:
Experience supervising staff in geographically diverse locations

Essential Responsibilities
Collaborate with Provider Relations Manager and provider network participants to develop, implement, and maintain provider training and education programs, policies and procedures, provider resource materials, and knowledge management that meet organizational business goals.
Collaborate with Provider Relations Manager, regional leadership, and provider network participants to identify opportunities and implement network improvements.
Take lead on team projects that improve patient access to care and provider network stability.
Research and resolve provider issues and concerns, especially those that are escalated from the team or other departments.
Work in partnership with Provider Relations and Contracting leadership to escalate and address contractual issues and concerns throughout CareOregon’s service area.
Actively participate in internal discussions regarding the evolving role of provider relations in supporting all lines of business.
Identify potential providers that may enhance the network and direct to the appropriate Provider Relations Specialist for recruitment.
Ensure that concerns and perspectives of provider network participants are represented at CareOregon and, in partnership with Contracting, Credentialing, and other lines of business leaders, recommend ways to improve patient access, network adequacy, and provider network stability.
Keep abreast of changes and advancedments in the Provider Relations, Medicare and Medicaid arenas.
Act as a resource for the Provider Relations Specialist team.
Coordinate, monitor, report on, and supervise the day-to-day operations and daily activities of the Provider Relations team.
Conduct monthly check-ins with Provider Relations staff as well as regional leadership to review, track, and collaborate on strategic priorities and Provider Relations annual goals.
Ensure the Provider Relations team effectively collaborates with other CareOregon teams, departments, and business partners.
Regularly attend recurring meetings as a representative of the Provider Relations team, and effectively disseminate relevant information, as needed.
Create and update documentation and resource materials for the Provider Relations team and other CareOregon departments, as needed.
Perform the functions of a Provider Relations Specialist, as needed.
Employee Supervision
Supervises team and recommends team direction and goals in alignment with the organizational mission, vision, and values.
Identifies work and staffing needs to meet work expectations; recruits and hires, using an equity, diversity, and inclusion lens.
Plans, organizes, schedules, and monitors work; ensures employees have information and resources to meet job expectations.
Leads the development, communication, and oversight of team and individual goals; ensures goals, expectations, and standards are clearly understood by staff.
Trains, supervises, motivates, and coaches employees; provides support toward employee development.
Incorporates guidance from CareOregon equity tools into people leadership, planning, operations, evaluation, and decision making.
Ensures team adheres to department and organizational standards, policies, and procedures.
Evaluates employee performance and provides regular feedback to support success; recognizes strong performance and addresses performance gaps and accountability (corrective action).
Performs supervisory tasks in collaboration with Human Resources as needed.

Organizational Responsibilities
Perform work in alignment with the organization’s mission, vision, and values.
Support the organization’s commitment to equity, diversity, and inclusion by fostering a culture of open mindedness, cultural awareness, compassion, and respect for all individuals.
Strive to meet annual business goals in support of the organization’s strategic goals
Adhere to the organization’s policies, procedures, and other relevant compliance needs.
Perform other duties as needed.

Knowledge, Skills and Abilities Required
Knowledge of Medicare, managed care, and the Oregon Health Plan
Familiarity with medical and behavioral health clinical operations
Strong skills in critical analysis, quantitative reasoning, creative problem-solving, and decision-making skills – especially in an environment with diverse staff, providers, and provider groups
Advanced computer application skills, including with Microsoft 365 Office products (including, but not limited to, Word, Excel, Outlook, PowerPoint), as well as Microsoft and Google-based internet browsers and search functions
Ability to communicate effectively verbally and in writing, including report writing and minutes recording
Ability to learn and apply continuous improvement concepts
Ability to interact and provide excellent customer service for a variety of internal and external customers with good judgment, personal initiative, and motivation, while performing assignments that may be confidential and sensitive in nature
Ability to lead in both a fully and semi-virtual environment
Ability to lead and communicate within a matrixed reporting structure
Ability to represent the organization in public and private meetings and other gatherings related to areas of specialty
Ability to conduct both virtual and in-person group training sessions and to make presentations as needed
Ability to work in an environment with diverse individuals and groups
Ability to work independently, organize, prioritize and manage multiple projects with short timelines
Ability to educate and give concise information through formal and informal provider education venues
Ability to develop and maintain professional relationships with providers, provider staff and other parties
Understand appropriate professional behavior, appropriate work ethic, and integrity

Physical Skills and Abilities Required
Lifting/Carrying up to 50 Pounds
Pushing/Pulling up to 0 Pounds
Pinching/Retrieving Small Objects
Crouching/Crawling
Reaching
Climbing Stairs
Repetitive Finger/Wrist/Elbow/
Shoulder/Neck Movement
0 hours/day
0 hours/day
0 hours/day
0 hours/day
0 hours/day
0 hours/day
More than 6 hours/day
Standing
Walking
Sitting
Bending
Seeing
Reading
Hearing
Speaking Clearly
1-3 hours/day
1-3 hours/day
More than 6 hours/day
0 hours/day
More than 6 hours/day
More than 6 hours/day
More than 6 hours/day
More than 6 hours/day
Ability to operate a motorized vehicle

Cognitive and Other Skills and Abilities
Ability to focus on and comprehend complex information, learn new skills and abilities, assess a situation and seek or determine appropriate resolution, accept managerial direction and feedback, and tolerate and manage stress.

Working Conditions
Environment: This position’s primary responsibilities typically take place in the following environment(s):
☒ Inside/office ☒ Clinics/health facilities (no member contact) ☐ Member homes
☐ Other: _____________________________________________________________
Travel: This position requires frequent travel outside of the workplace, in which the employee’s personal vehicle may be used. Driving infractions will be monitored in accordance with organizational policy.
Equipment: General office equipment and/or mobile technology
Hazards: N/A
Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment
Veterans are strongly encouraged to apply.
Equal opportunity employer. This company considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.

Position Description »