Provider Relations Director at ModivCare in Southfield, Michigan

Job Description:

Provider Relations Director
21-6436

The Provider Relations Director defines, implements, and maintains a compliant, effective and efficient Transportation Provider Network in their assigned market(s). They will ensure on-going network development and available contract rate capacity through commitment to overall network health.

The Provider Relations Director will have operational responsibility for the management and successful leadership of all programs across their market(s). They will provide direction and close guidance in managing on-going transportation supplier relationships through communicating with all Provider Relations Managers/Coordinators. Reporting to the Network Regional Director they will manage the everyday workings of the Provider Relations program, including but not limited to overseeing implementations, trainings, remediating issues with Transportation Providers, ensure PRM compliance with appropriate procedures, and providing timely and accurate reporting to senior leadership. The Director will provide leadership support on the development, implementation and execution of all deployments, special projects or other Network Health related actions.

Reporting Relationships:
HR oversight for Provider Relations & Network Operations Leadership

Departmental Relationships:
The Provider Relations Director has frequent and significant contact with field operations as well as internal corporate departments.

ESSENTIAL FUNCTIONS

• Ensuring Network Capacity: consistent network development


• Managing Cost of Transportation (unit cost)


• Managing Company vehicle & maintenance oversight for working group


• Performing HR oversight for Management level employees.


• Liaise with Network Development team on capacity strategies, develop & oversee execution of action plans


• Liaise with Network Services team on provider compliance as part of provider performance oversight


• Ensures overall network health for the assigned market/area through on-going network development and individual provider relations support.


• Executes on-going network development to prevent network deficiencies and meet or exceed budgeted unit cost.


• Manages transportation provider network contracts to ensure that performance criteria are met and maintained.


• Oversees the onboarding of transportation providers to include contracting and negotiating rates.


• Ensure credentialing policies are followed and standards are adhered to.


• Develop metrics and implement plans to execute on-going network development to manage network deficiencies.


• Ensure delivery and review of the provider performance reviews.


• Supports the negotiations with provider networks to meet budgeted costs.


• Oversight of corrective action plan administrations for transportation provider contract deficiencies and approves liquidated damages as appropriate.


• Approves new provider contracts, settlement deductions and other payments as needed.


• Engages in provider relations support to initiatives for overall provider business management support (i.e. assisting with grants for vehicles, strategies for hiring and maintaining quality drivers)


• Responsible for overall Network Digitization and assumes role of subject matter expert for all digitization initiatives.


• Responsible for overall platform utilization (transition & implementation).


• Develops ongoing relationship with transportation providers & outside agencies relevant to network health and provider business support.


• Manages problem resolution and quality monitoring including provider complaint reports.


• Supervisory Responsibilities




• Responsibilities include interviewing, hiring, training Provider Relations and Network Operations Managers and ensuring they maintain approved FTE for reporting positions; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.




• Other duties as assigned.

POSITION QUALIFICATIONS

Education

• Bachelor's degree or equivalent work experience

Experience

• 3 to 5 years of relevant analysis experience required


• Experience in the medical or human services transportation preferred


• 2 to 3 years of supervisory experience required


• Transportation, routing, or, dispatching experience and/or knowledge of transit system a plus


• Knowledge of Medicaid guidelines a plus


• Driving Requirements:




• Must have a valid driver's license


• Must be able to pass DMV record check


• Driving record must remain in compliance with ModivCare's driver qualification standards


• Must be able to use a hands-free mobile phone

Skills & Experience

• Strong analytical and reporting skills


• Knowledge of organizational planning, budgetary administration and controls


• Knowledge of statistical and financial analysis techniques


• MS Office (Outlook, Excel, Word, PowerPoint)


• Qlik Sense experience preferred


• Excellent provider relations management


• Advanced industry experience


• Excellent process and design improvement skills


• Strong risk management skills

TRAVEL

• 50% required
  
  

We value our team members and realize the importance of benefits for you and your family.

• We offer a comprehensive benefits package to include the following:


• Medical, Dental, and Vision insurance


• Employer Paid Basic Life Insurance and AD&D


• Voluntary Life Insurance (Employee/Spouse/Child)


• Health Care and Dependent Care Flexible Spending Accounts


• Pre-Tax and Post --Tax Commuter and Parking Benefits


• 401(k) Retirement Savings Plan with Company Match


• Paid Time Off


• Paid Parental Leave


• Short-Term and Long-Term Disability


• Tuition Reimbursement


• Employee Discounts (retail, hotel, food, restaurants, car rental and much more!!)

Salary starting at: $80,324

Bonus eligible based upon individual and company performance

ModivCare is an Equal Opportunity Employer.