BlueCross BlueShield of Tennessee Supervisor Support Services (Provider Relations) in Nashville, Tennessee

The position manages the Provider Relations unit within Behavioral Health Programs. Supports Provider Relations and executive management with the resolution of issues and root cause analysis of issues that are presented to them from our network providers. This position is accountable for the operation that offers the providers an avenue to resolve issues that may not or can not be resolved at the service department level. The operation is designed to listen for ways to improve our products and service to all providers networked with BCBST.

Job Description:

Job Duties & Responsibilities

  • Manage the Provider Relations staff, including performance reviews.
  • Responsible for proactively finding ways for the corporation to improve provider relations, by working closely with Behavioral Health staff, Regional Provider Relations, PSO Management, Provider Contracting and Reimbursement areas.
  • Responsible for proactive communication and education of providers and provider relations on business interaction, procedural and relationship issues.
  • Monitors the handling of provider issues so as to ensure accurate completion as well as satisfactory turnaround time based on department standards.
  • Oversee the total operation of the department to verify that the budget parameters are met on an ongoing basis.
  • Produce weekly, monthly and annual performance reports.
  • Meets on site and off site with provider group staff as part of our issue resolution and proactive education process.
  • Represents the program at quarterly Town Hall meetings
  • Ensure education and outreach objectives are met.
  • Hire, develop, motivate and coach a diverse and qualified staff of individuals, including exempt and non-exempt employees.
  • Available to employees on a daily basis in order to facilitate prompt and accurate service to internal and external customers.
  • Responsible for continuous education of potential problem areas and new and upcoming changes.
  • Organizes the workload in the department to maximize productivity, improve efficiency and enhance workflow.
  • Identify, research, and resolve high profile issues.

Job Qualifications

Education

  • Bachelor’s degree or equivalent work experience. (Equivalent experience is defined as one year of professional experience for each year of college requested).

Experience

  • Minimum 5 years experience in healthcare industry required.
  • Minimum 3 years supervisory or leadership experience required.

Skills/Certifications

  • Requires leadership characteristics in order to motivate a wide range of employees as well as handle the daily management decisions.
  • Requires working knowledge of the FACETS system.
  • Excellent communication skills
  • Solid Microsoft Office skills with emphasis in Excel and Access.
  • Ability to travel.

Job Specific Requirements:

Provider relations experience is highly preferred

Employee management experience preferred

Program implementation experience preferred

Number of Openings Available:

1

Worker Type:

Employee

Worker Sub-Type:

Regular

Company:

VSHP Volunteer State Health Plan, Inc

BCBST is an Equal Opportunity employer (EEO), and all employees and applicants will be entitled to equal employment opportunities when employment decisions are made. BCBST will take affirmative action to recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or membership in a historically under-represented group.

BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.

Tobacco-Free Hiring Statement

To further our mission of peace of mind through better health, effective 2017, BlueCross BlueShield of Tennessee and its subsidiaries no longer hire individuals who use tobacco or nicotine products (including but not limited to cigarettes, cigars, pipe tobacco, snuff, chewing tobacco, gum, patch, lozenges and electronic or smokeless cigarettes) in any form in Tennessee and where state law permits. A tobacco or nicotine free hiring practice is part of an effort to combat serious diseases, as well as to promote health and wellness for our employees and our community. All offers of employment will be contingent upon passing a background check which includes an illegal drug and tobacco/nicotine test. An individual whose post offer screening result is positive for illegal drugs or tobacco/nicotineand/or whose background check is verified to be unsatisfactory, will be disqualified from employment, the job offer will be withdrawn, and they may be disqualified from applying for employment for six (6) months from the date of the post offer screening results.

Resources to help individuals discontinue the use of tobacco/nicotine products include smokefree.gov or 1-800-QUIT-NOW.

About Us

As Tennessee's largest health benefit plan company, we've been helping Tennesseans find their own unique paths to good health for over 65 years. More than that, we're your neighbors and friends – fellow Tennesseans with deep roots of caring tradition, a focused approach to physical, financial and community good health for today, and a bright outlook for an even healthier tomorrow.