Director, Provider Engagement

Become a part of our caring community   The Director, Indiana Medicaid Provider Services, leads a team accountable for growing positive, long-term relationships with LTSS providers. We do this in order to foster positive provider experiences, submit accurate and timely provider claims, and deliver high-quality care among network providers. , this leads to improved financial and quality performance. This senior market leader will oversee a team of direct and indirect reports responsible for provider relations and training, claims education, provider engagement and practice transformation. They set strategic direction for those accountable departments. They represent the team at meetings with the state or main provider groups. They oversee provider services functions to meet contractual requirements and complete state reports timely and accurately. The Director, Provider Services, requires an in-depth understanding of how organization capabilities interrelate across the team, IN Medicaid market, and the enterprise. This is a dynamic role requiring experience. This position is dedicated to the Indiana Medicaid plan and must be based in or willing to relocate to Indiana. • Set strategic direction for and oversee main departments, including provider relations and training, claims analysis and education, provider payment performance, and practice transformation • Develop operational procedures to align with the provider services model and execute on strategic programs within the provider network • Allow the growth of positive, long-term relationships with LTSS/HCBS providers to foster provider retention and improve financial and quality performance within the contracted working relationship with the health plan. • Provide Indiana market oversight and governance of provider audits, provider surveys, provider service and relations, and provider feedback. • Review reports provider complaints data and trends, claims denials/rework data and trends, provider training and communications, and provider performance data in order to monitor team performance and guide strategic Improvements where needed • Represent the provider services team at all state meetings. Meet with main providers, and provider associations • Ensure team's compliance with Indiana's Managed Care Contractual requirements for provider relations, such as claims dispute resolution within specified timeframes • Set and monitor team measurements and strategic goals • Work enterprise teams on provider call center, claims processing, reporting, contracting/credentialing, network adequacy, provider dispute resolution issues, and provider performance tracking and tool enhancements. • Plan and build regular and ad hoc provider communications and strategy for provider training • Conduct regular performance evaluation of employees and provide ongoing feedback to achieve service, quality, and production goals. Identify and support professional development for their team to grow associate engagement and performance Use your skills to make an impact   Required Qualifications • Master's Degree or equivalent experience • 8 or more years Provider Contracting or Relations experience • Knowledgeable on Federal/State contractual provider requirements • 5 or more years of management experience • Project management and initiative oversight experience • Ability to travel • Knowledgeable on provider contracting and credentialing processes • Must be passionate about contributing to an organization focused on improving consumer experiences • Must Reside in Indiana and will attend meetings in the Indianapolis office Preferred Qualifications • Prior work experience in the health solutions industry with expertise directing and leading teams • Proficiency in quality improvement proc