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Program Manager, Provider Engagement

The Program Manager for Provider Engagement is responsible for building and maintaining relationships with key provider partners to achieve the organization’s network partnership and performance objectives.  Position will focus on establishing and maintaining robust clinical and programmatic collaboration, communicating with provider partners on program performance, addressing provider issues, and facilitating efficient and effective implementation of the company’s model of care and strategic objectives, including facilitation of membership growth in CCA programs.

Duties & Responsibilities
  • Reporting to the Senior Director of Provider Engagement, the Program Manager is responsible for the programmatic engagement of assigned primary care practices, health systems, and/or other providers and community based organizations as assigned, as well as collaboration with CCA internal departments including clinical, provider contracting, operations, analytics, and member outreach.
  • Work with contracting, clinical and operations leadership to effectively onboard new providers and the transition process in cases of provider terminations..
  • Work with senior leadership at health care providers and other entities as needed to promote shared marketing strategies, and to meet enrollment targets.
  • Works with CCA provider network planning and analysis to identify and develop new provider relationships necessary for growth and/or quality of CCA programs.
  • In partnership with Business Intelligence, Finance, and Network Planning and Analysis, develop and share performance reporting documents and deploy analytics to support communication with the network and drive performance improvements.
  • Work with key network partners to foster improved communications, deepen clinical and programmatic partnerships, address and resolve operational issues, grow membership, facilitate specific initiatives, and drive overall performance.
  • Serve as internal champion for these key internal and external provider organizations, working cross-functionally and pro-actively to address provider needs, eliminate obstacles, and resolve issues that arise. Liaise between contracted practices and internal clinical groups to facilitate communication, process improvements, and issue resolution.
  • Collaborate with provider contracting team in the development of contract and reimbursement terms to strengthen network partnerships.
  • In order to fulfill primary duties and responsibilities, convene and oversee cross-functional workgroups, where appropriate, to serve assigned primary care and health systems
  • Work collaboratively with Provider Contracting and Strategy to contribute to overall provider network strategy and growth consistent with company strategic objectives.

  • Bachelors degree required
  • Minimum of 3-5 years of working with health care providers, business development, performance management, contracting and analytics. 
  • Minimum 3-5 years working with cross-functional interdependencies and proven ability to manage large multiple projects simultaneously in a deadline-driven environment. 
  • Professional poise and comfort with leading discussions with senior leadership, professional clinical staff, and others, including outside vendors and customers. 
  • Knowledge of health care marketplace
  • Experience developing strong relationships within providers
  • Requires excellent presentation skills on a wide range of content on CCA– to internal and external senior leaders
  • Understanding of health care finance and standards for measuring performance
  • Strong analytic skills
  • Must be able to influence team members, business owners across different business units and senior leaders
  • Must act as a champion for network providers
  • Demonstrated ability to develop and utilize an escalation path for an issue
  • Must be highly organized and self-directed
  • Must be able to work collaboratively and cooperatively as a team member or leader, fostering an atmosphere of trust and respect
  • Must be able to communicate effectively across all levels of the organization verbally and in writing

Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.
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