Provider Relations Network Manager

Motion Picture Industry Pension & Health Plans has an opening for a Provider Relations Network Manager in our MP3 (Motion Picture Preferred Provider) Network. The MP3 Provider Network Manager will work closely with the Chief Medical Officer and Medical Review Director to review, prepare, and coordinate MP3 Provider applications and new provider onboarding.

At the Motion Picture Pension and Health Plans (MPIHP), the Medical Review Department is responsible for Utilization Management for the Plan. MP3 is the narrow provider network; this role will be responsible for managing the application process for new Provider applicants.

Qualifications

• Minimum four (4)+ years of experience in Physician Narrow Network/ Preferred Provider Services.
• Relevant Bachelor’s degree or equivalent combination of experience and education
• Project planning, project management experience required.
• Demonstrated ability to utilize/apply the general and specialized principles, practices, techniques, and methods of utilization management.
• Working knowledge and familiarity of regulatory requirements and accreditation standards
• Excellent verbal and written communication, presentation, and public speaking skills
• Intermediate to advanced proficiency using Microsoft Office
• Demonstrated critical thinking, analytical and problem-solving skills.
• Ability to communicate effectively at all levels of the organization, and externally in situations requiring instructing, persuading, negotiating, consulting, and advising.
• Highly organized with planning, prioritization, goal setting, and time management skills
• Ability to work independently and as a member of a larger team.
• Clear motor vehicle record for local travel to provider facilities
• Excellent attendance and reliability
• Ability to work extended hours as required.
• Ability to accept direction and developmental guidance from supervisor.

Responsibilities

Providers:

• Send and track letters of agreement (LOAs) for physicians and user agreements for users.

Receive and store signed LOAs for physicians and user agreements for users.Identify PCP referral patterns and recommend specialist additions.Work with MP3 team to evaluate and address specialist network gaps.Training:

• Training physicians and users on MP3 rules

Training physicians and users on the Medecision/Aerial referral systemWriting and sending approved communications about MP3Provider offices:

• Regular virtual meetings (via Zoom) and occasional site visits to answer questions and solve problems.

MPIPHP website:

• Work with MP3 system administrator and IT to maintain the MP3 website including the provider lists.

Work with MP3 system administrator and IT to create and train providers on the Provider Portal

Participants:

• Work with MP3 team to educate Participants on the network additions.

Create digital and written resources for Participants regarding MP3 related topics.Act as a liaison to Participants to help them solve provider network adequacy issues.

• Understand and utilize the Summary Plan Description
• Attend interdepartmental and organizational meetings as needed.
• Ensure all departmental correspondence is accurate and up to date.
• Other duties as assigned.

The anticipated base salary for this position is $95,000- $105,000 annually The actual base salary offered will depend on a variety of factors, including without limitation, the qualifications of the individual applicant for the position, years of relevant experience, level of education attained, certifications or other professional licenses held.

Physical Demands and Work Environment:

The physical demands described here are representative of those that must be met by an employee to successfully perform the job requirements.

Work is performed in a standard office environment. While performing the duties of this job, the employee is required to:

• Sit
• Stand or walk
• Extensive time spent working on the computer
• Talk and hear
• Use hands
• Reach with hands and arms
• Stoop, reach for filing and shredding documents
• Vision abilities required by this job include close vision and the ability to adjust focus.
• The employee is regularly required to lift and/or move up to 10 pounds and may occasionally be required to lift and/or move up to 30 pounds (such as a box of paper).
• Some local travel by car may be required

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

COVID-19 considerations:

All employees must be fully vaccinated against Covid-19. Work stations are socially distanced and high touch point areas are sanitized routinely.

Motion Picture Industry Pension & Health Plans