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Supervisor Provider Services
Provider Services Supervisor
In conjunction with the Director of Operations – Provider Services and Claims, the Provider Services Supervisor is responsible for assisting with operational functions of HealthTeam Advantage’s (HTA) provider networks and vendors. This includes assisting with the coordination of processes and oversight including, but not limited to direct oversight of the Provider Services team, recruitment, contracting, credentialing, provider relations, education, provider directory, claims, and operations. This position also collaborates with other areas within HTA to help resolve provider issues and to help ensure quality requirements are met
Major Work Activities
Directly oversees Provider Concierge’s, the Plan’s provider call center representatives.
Oversight of performance expectations including but not limited to attendance, schedule adherence, and performance in operational metrics
Deliver regular feedback aimed at helping associates understand their performance and continuously grow in the role
Engage in performance management activities as needed
Contribute to a culture of customer advocacy, continuous improvement, and exceptionally high standards
Direct handling of escalated contacts as needed
Act as an owner of overall team performance; actively monitor all work queues and respond rapidly when additional support is required
Motivate team members to perform their best work in a fast-paced environment where change is the norm
Participate in process improvement and process change projects, including operational readiness components of new process launches
Provide daily direction and communication to the team so that customer service calls are answered in a timely, efficient, and knowledgeable manner.
Provide continual evaluation of processes and procedures, which includes reviewing calls and providing evaluations for improvement/development.
Provide guidance on ensuring correct decisions is determined during calls.
Provide ongoing coaching to any area needing improvement
Provide feedback on audit corrections/updates needed.
Train new and re-train tenured PCs on new processes to improve the customer experience.
Monitoring real-time service levels and schedule adherence.
Monitor call metrics and develop a corrective action plan when necessary.
Establish creative ways to increase team performance
Ensure efficient use of staff during peaks and downtime
Responsible for supporting, coordinating, and overseeing provider relations as it relates to claims processing, provider education, provider orientations/onboarding, contracting and credentialing, and provider data management.
Develops provider engagement strategies and procedures to increase provider satisfaction
Develops and maintains provider onboarding process
Develop and implement complaint process to ensure timely and accurate resolution
Identify areas of opportunity and document workflows/processes to affect positive changes
Supports network by monitoring and communicating trends and issues that may affect relationships.
Assists Director of Operations with network obligations and provider relations including, but not limited to maintaining rosters and directories, monthly provider newsletter
Other duties as assigned
Bachelor’s Degree in business, or other healthcare-related field or three (3) or more years equivalent work experience
Two (2) or more years experience with Medicare Advantage provider relations and/or provider network management
One (1) or more years experience in credentialing and contracting
One (1) or more years experience in claims review and processing.
Two (2) years or more supervisory experience in a related field.
Strong in Word, Excel, and PowerPoint
Knowledge, Skills, and Abilities
Understanding of Medicare Advantage and Part D Programs
Strong in the following competencies:
Outstanding interpersonal skills including Active Listening, Social Perceptiveness, Speaking, and Critical Thinking Skills
Self-motivated with excellent follow-through
Ability to provide a team-oriented work environment that delivers a positive team culture
Experience working with regulatory agencies
Preferred Knowledge, Skills, and Abilities
Knowledge of provider practice and ancillary provider operations.
Time: Full time
Updated: 3/17/2021 3:12:21 PM