Substance Use Provider Network Manager - LP (Remote NC)

LOCATION : Remote - this is a home-based, virtual position that operates Monday-Friday from 8 : 30am-5 : 00pm EST. Candidates may live anywhere within Vaya's catchment area. Incumbent must maintain residency in North Carolina or within 40 miles of the NC border.

GENERAL STATEMENT OF JOB

The Substance Use Provider Network Manager - LP is responsible for maintaining ongoing, collaborative relationships with community stakeholders and providers to support the development and management of the provider networks while maintaining the highest level of customer service. The Substance Use Provider Network Manager - LP will drive the improvement of provider performance by analyzing and interpreting both quantitative and qualitative data to address and prioritize network needs. This role will specifically focus on the unique needs of providers providing Substance Use providers across all levels of care and funding sources.

Vaya's Provider Network is tasked with providing focus for epidemics that impact our communities. The Substance Use Provider Network Manager - LP is tasked with providing focused support and shall have a majority (but not limited to) caseload focused on the specific treatment. In times of requirement to focus on a specific epidemic the Substance Use Provider Network Manager - LP will serve as the internal and external resource that knows services available in the network, actively pursues, addresses and fills gaps in the focused epidemic treatment services. The employee will partner with internal work teams, often leading such project teams, to assure access to the assigned epidemic's treatment and recovery programs across the Vaya network. The employee ensures that engagement with contracted providers is consistent and in line with contract obligations. This position will be focused on funded initiatives focused on the epidemic. The key function of the employee during times Vaya is tasked with focusing on a specific epidemic is to ensure that there is coordination among the various streams of state and / or federal funding coming into the organization to address the targeted epidemic. This employee will serve as a fundamental team member in administering and coordinating the implementation of federal grants withing Vaya that focus on various aspects of the focused epidemic.

Note : This position requires access to and use of confidential healthcare information or protected health information (PHI) as described in laws addressing patient confidentiality, including, but not limited to, the federal HIPAA law, the Confidentiality of Alcohol and Substance Abuse Patient Records law, 42 CFR Part 2, and various state laws. As such, the individual filling this position shall be required to be trained regarding such laws and shall be required to observe those laws in his / her capacity as an employee of Vaya Health. The individual filling this position shall also sign a confidentiality statement as an employee of Vaya Health.

ESSENTIAL JOB FUNCTIONS

Provider Network Management :

• Collaborate with SU network providers to assure contracts are executed and providers receive necessary technical assistance
• Develop, direct, support, and oversee initiatives specific to focused epidemics as assigned to the business
• Facilitate provider education and training to increase provider familiarity, alignment and satisfaction with Vaya Health's (Vaya) systems, expectations, and strategies. Lead development of network training initiatives and manage coordination with external education vendors as assigned.
• Participate in development of provider operational manuals and educational materials that are tied directly to established clinical coverage policies as assigned
• Study and design innovative SU programs to create and enhance access to quality care
• Work independently and cross-departmentally to ensure that Vaya maintains accreditation standards (e.g. URAC, NCQA, etc.) and DHHS Waiver requirements related to its provider network
• Apply network configuration and incentive-based payment models as appropriate to improve quality services and efficiency
• Facilitate provider contract meetings with high impact providers to proactively address access or quality issues.
• Proactively triage provider complaints and ensure appropriate follow up in instances where work flows or infrastructure are not functioning properly
• Facilitate programs that positively impact markets of stakeholders and members
• Answer, log, track, and respond to all provider calls and emails received through the Vaya provider phone line or email address
• Establish relationships with provider agencies and Vaya Board members as needed to facilitate the goals of the network, meet member needs, and enhance relationships with Vaya
• Manage, oversee, and implement plans in times when Vaya is tasked with focusing on a specific epidemic
• Complete assigned elements of annual network development plan ensuring completion of assigned elements by date identified each calendar year and present information to internal and external stakeholders as assigned
• Update internal policies and procedures as assigned
• Provide expertise for stakeholders groups mandated by contract and as assigned

Provider Contracts :

Data & Reporting :

Other duties as assigned.

Note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Incumbent in this position will also be cross-trained to be able to perform the duties of the Substance Use Provider Network Manager (Bachelor's Level) and will be able to assist and / or provide coverage to complete time sensitive, required duties should there be a need.

KNOWLEDGE, SKILLS, & ABILITIES

EDUCATION & EXPERIENCE REQUIREMENTS

Master's degree in a Human Services field required. Must have

Licensure / Certification Required :

Preferred Experience :

PHYSICAL REQUIREMENTS

RESIDENCY REQUIREMENT : The person in this position is required to reside in North Carolina or within 40 miles of the North Carolina border.

SALARY : Depending on qualifications & experience of candidate. This position is exempt and is not eligible for overtime compensation.

DEADLINE FOR APPLICATION : Open Until Filled

APPLY : Vaya Health accepts online applications in our Career Center, please visit https : / / www.vayahealth.com / about / careers / .

Vaya Health is an equal opportunity employer.