Community Supports Provider Relations Manager

What you can expect! 

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

Reporting to the Manager of Community Supports, the IEHP Community Supports Provider Relations Manager (CS PRM) is responsible for developing and maintaining a robust network of potential and contracted Community Supports network providers to ensure service adequacy, quality, and compliance with federal, state, and local regulations. This role serves as the primary liaison and subject matter expert for all CS services associated with their assigned providers, fostering strong partnerships to drive operational excellence, facilitate redesigning efforts, introduce population health initiatives, and support achievement towards clinical outcomes and value-based care. The incumbent serves as the primary point of communication with the CS Provider and maintains oversight of the relationship from inception of the CS Provider’s relationship with IEHP onwards. The CS PRM leads provider engagement, onboarding, training, and performance improvement efforts, while supporting strategic initiatives to expand and strengthen the Community Supports network in alignment with IEHP’s mission and strategic goals. In addition, the CS PRM is responsible for recruiting new CS Providers into IEHP Community Support Network as well as identifying opportunities to develop the Community Supports network to meet IEHP quality metrics, service goals, and compliance standards.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

• Competitive salary
• State of the art fitness center on-site
• Medical Insurance with Dental and Vision
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development
• Wellness programs that promote a healthy work-life balance
• Flexible Spending Account – Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance

Education & Requirement

• Three (3) or more years of experience with customer service in a health services setting including Hospital, Managed Care, Medical Group, IPA, and/or HMO
• Experience with managed care
• Experience working in the community with community-based organizations (CBO’s)
• Bachelor's degree from an accredited institution required
  • In lieu of the required degree, a minimum of four (4) years of additional relevant work experience in Community Supports is required for this position. This experience is in addition to the minimum years listed in the Experience Requirements above.
  • Master’s degree from an accredited institution preferred

Key Qualifications

• Must have a valid California Driver’s license and valid automobile insurance.   Must qualify and maintain driving record to drive company vehicles based on IEHP insurance standards of no more than three (3) points. 
• Knowledge of Community Support Services
• Working knowledge of Medical Group, IPA, CBO’s and HMO operations
• Proficiency in utilization of all Provider Services databases and systems
• Strong organizational skills. Excellent written and verbal communication and interpersonal skills
• Microcomputer Applications (Microsoft Word and Excel, Access Preferred) for use in all aspects of an office environment
• Skilled data input
• Skills in proactively engaging with providers and staff to determine root cause and address business issues (such as administrative, regulatory and customer service matters)
• Training skills to educate providers and provider staff as needed, which may include counseling providers diplomatically, while retaining a positive working relationship
• Skills in network development, by monitoring and enforcing company policies and procedures, while increasing Provider effectiveness by educating and promoting participation in various IEHP initiatives
  • Examples of such initiatives include administrative cost effectiveness, member satisfaction - CAHPS, regulatory-related, IEHP Quality programs, and taking advantage of electronic solutions (EDI, EFT, EMR, Provider Portal, Provider Website, etc.)
• Proven ability to:
  • Provide clear directions, set expectations, and motivate community partners to achieve goals
  • Make informed, timely decisions using data, judgment, and stakeholder input
  • Communicate clearly both verbally and in writing - with diverse audiences
  • Build strong trust-based relationships with partners and stakeholders
  • Demonstrate a strong sense of ownership of IEHP’s relationship with the Provider that recognizes the Provider as a valuable partner
  • Independently troubleshoot and problem-solve issues as they arise, making an assessment when escalating to a CS Manager, Director, or another IEHP department as needed and initiating, coordinating, and participating in problem-solving meetings between the Provider and IEHP stakeholders, including senior leadership and Providers
  • Take initiative in preventing and resolving issues between the Provider and IEHP whenever possible
  • Independently deliver training and presentations to assigned Providers and their staff, answering questions that come up on behalf of IEHP. May also deliver training and presentations to larger groups, such as leaders and management of Provider offices

Start your journey towards a thriving future with IEHP and apply TODAY!

Pay Range

• $71,572.80 USD Annually - $93,038.40 USD Annually