Provider Network Supervisor

Responsibilties: Performs completed staff work to ensure the availability of relevant, trusted healthcare and benefits physicians (e.g., data collection, preparing presentation materials, and reviewing/evaluating applications and submitted documentary requirements). Negotiates contracts that comply with industry regulations while applying risk-minimizing techniques. Initiates collaboration with other Maxicare divisions/departments to identify and pursue better provider networks. Negotiates terms and conditions of contracts with physicians, ensuring alignment with organizational objectives and regulatory requirements. Provides inputs and ensures the drafting, reviewing, and finalization of contracts. Serves as the primary point of contact for contract-related inquiries and issues. Collaborates cross-functionally with internal divisions (e.g., Legal, Finance, Operations, Provider Network Management) to ensure seamless contract execution and alignment with organizational objectives. Conducts monitoring and regular visits to the Preferred Physician Network and other affiliated physicians to resolve relevant issues raised by internal and external stakeholders. Completes performance evaluation reports and communicates the performance evaluation results. Serves as the primary point of contact for physician inquiries and resolves concerns regarding claims submission, payment, contract renewal, and updates on Maxicare medically-relevant policies and guidelines. Implements appropriate physician development strategies to foster a culture of collaboration, continuous improvement, and shared success. Resolves cases of delayed discharge due to physician excess fees and maintains visibility and escalations for balance billing. Qualifications: Bachelor’s Degree in Business Administration, Healthcare Administration, Nursing, Public Health, Mass Communication, Marketing, or a related field. Professional Background: At least 2 to 3+ years of experience in healthcare operations, provider relations, client management, or contract management. Industry Experience: Direct work experience within an HMO, Health Insurance, Hospital Administration, or Healthcare Delivery setting is strongly preferred. Leadership Experience: Experience acting as an individual contributor with project lead responsibilities, or basic team lead/supervisory experience (given the Supervisor level).