Provider Network Relationship Manager (Ohio)
Core
Manage provider networks for Ohio Medicaid's OhioRISE program, focusing on behavioral health services for children with complex needs.
Role type
Provider Network Relationship Manager
Builds
Comprehensive behavioral health service networks for children in Ohio Medicaid
Domain
Healthcare / Medicaid Managed Care / Behavioral Health
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
Medicaid managed care expertise, provider relationship management, contract compliance review, claims data analysis, cross-functional collaboration, strategic network configuration
Preferred skills
Behavioral health market knowledge, Ohio managed care market experience
Technologies
MS Office Suite
Responsibilities
Optimize interactions with assigned providers to establish and maintain productive relationships; Collaborate cross-functionally to resolve escalated issues and monitor performance against scorecards; Educate parties on contract policies, plan design, and performance measurement; Meet with key providers to ensure service levels; Manage agendas and facilitate external provider meetings; Collaborate on large provider system implementations to manage cost drivers; Drive provider engagement and recruitment for network expansion; Assist in designing and implementing strategic network configurations.
Seniority
Mid-Senior level, individual contributor
