Department Name:

Care Transformation

Work Shift:

Day

Job Category:

General Operations

Estimated Pay Range:

$32.09 - $53.48 / hour, based on location, education, & experience.

In accordance with State Pay Transparency Rules.

Banner Plans & Networks (BPN) is an integrated network for Medicare and private health plans. Known nationally as an innovative leader, BPN insurance plans and physicians work collaboratively to keep members in optimal health while reducing costs. Supporting our members and vast network of providers is a team of professionals known for innovation, collaboration, and teamwork. If you would like to contribute to this leading-edge work, we invite you to bring your experience and skills to BPN.

The Care Transformation Program Manager will support network performance by organizing, structuring and analyzing performance data to identify operational opportunities, trending data and developing reports that will be used in a variety of meetings. Will be responsible for creating solutions, not managing established processes.

The ideal candidate will have a strong data analytics and data reporting background with Excel and PowerBI experience.

Schedule Generally Monday - Friday 8am - 5pm

Hybrid most work can be done remotely with occasional travel to Phoenix Corporate or Mesa Corporate.

Banner Plans & Networks (BPN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BPN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.

POSITION SUMMARY

This position provides oversight of the Care Transformation department initiatives, projects, communications and operational work that is provided by the Care Transformation department.  This position will support leadership in development and implementation of processes to increase efficiency and effectiveness in successfully achieving department and organizational goals.

CORE FUNCTIONS
1. Serves as an example to peers for both behaviors and performance of job functions. Provides Managerial Care Transformation experience and training to Care Transformation representatives, and acts as a knowledge resource for internal customers. Serve as a primary resource in complex and/or sensitive cases.

2. Provides coaching, training, staff development, mentoring and overall support to assigned staff. Participation and responsibilities related to performance evaluation, performance improvement, coaching, training, mentoring, and time card processes. Creates a strong culture of engagement, inclusiveness, creativity, knowledge sharing to support the provider relations team and department.

3. Provides collaborative approach with leadership, partner departments and contracted providers in leading this work.

4. Create, develop, and manage communication materials, letters, content for provider newsletters, power point presentations, and other Care Transformation or provider communication resources as required.

5. Oversee, coordinate, and support provider engagement, and communications.  Maintains all levels of communication with network providers, informing them of any operational, procedural, and contractual changes and updates.

6. Support Directors to consistently meet monthly goals as determined by management. Assists Directors with network development in various geographic regions within the organization, negotiates, implements and maintains managed care initiatives with payers and providers.

7. Works cohesively with appropriate parties to ensure delivery of outstanding customer service while facilitating timely research and issue resolution, in a positive work environment, that supports the department’s ongoing goals and objectives.

8. Works on special projects as assigned.

9. Assists in the development and maintenance of a comprehensive provider network for Banner Networks. The incumbent must have a thorough understanding of managed care, medical office procedure, provider relations experience, medical claims and contracting. In addition, the incumbent must have excellent verbal and written communication skills, determine work priorities and is expected to accomplish all tasks with minimal supervision and instruction. Experience required in direct supervision and coaching of assigned teams. Analytical knowledge required.

MINIMUM QUALIFICATIONS

Must possess a strong knowledge of healthcare as normally obtained through the completion of a bachelor’s degree in business, healthcare administration, or related work experience.

Requires a proficiency level typically acquired through a minimum of four years of experience in healthcare operational/financial management or related field.

Must have an excellent understanding of medical terminology and knowledge of CPT and ICD-10 coding. Must have an understanding of HEDIS, STARS and other value-based performance initiatives as required by government programs. Must have the ability to effectively communicate both verbally and in writing.

Must know how or learn to program data retrieval utilities and queries. The incumbent must possess the ability to track and analyze statistical data. This position requires a mathematical aptitude, computer experience, typing skills and the ability to work on a variety of projects in an organized fashion.

 

Adept at creating and communicating a clear and detailed program plan to internal/external stakeholders, effectively aligning resources and motivating multi-disciplinary teams to achieve goals and create partnership-style relationships. Demonstrated technical, organizational, project management and negotiation capabilities. Proficient in written communications, power point and presentations. Must be a self-starter with excellent ability to implement and execute. Ability to balance the big picture with the day-to-day delivery details, connecting key project needs and internal resources to prioritize the workload. Strong desire to improve the lives of patients, their care givers, and families. Possesses compassion and empathy coupled with accountability and execution.

Requires proficiency in the use of sophisticated software programs.

PREFERRED QUALIFICATIONS

Five to ten years of experience in the healthcare field preferred, preferably in a managerial or supervisory capacity. Two years of medical office and/or provider representative experience is preferable.

Additional related education and/or experience preferred.

EEO Statement:

EEO/Disabled/Veterans

Our organization supports a drug-free work environment.

Privacy Policy:

Privacy Policy