Manager, Provider Network – Medicare

Job not on LinkedIn

November 2

⛰️ Colorado – Remote

Although this job is listed in Colorado, this company may be open to hiring remote in other states.

💵 $100k - $135k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

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Group 1001

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Finance • Insurance • Education

Group 1001 is a collective focused on empowering companies and communities through innovative financial solutions and strategic partnerships. The company provides simple and accessible insurance and annuity products designed to help individuals manage and grow their savings. Their online investing platform offers users a digital means to control their financial futures. Group 1001 also invests in partnerships that enhance community development through education and sports. With a tech-driven culture, they are transforming the insurance industry and helping communities thrive.

501 - 1000 employees

💸 Finance

📚 Education

📋 Description

• Oversee the recruitment, contracting, and onboarding of providers across all specialties. • Negotiate provider agreements, fee schedules, and amendments in alignment with company policy and CMS regulations. • Build and maintain strong, collaborative relationships with providers. • Oversee day-to-day provider relations functions including onboarding, engagement, and issue resolution. • Monitor provider satisfaction and implement initiatives to improve the provider experience. • Ensure all contracting and credentialing activities adhere to CMS, state, and NCQA standards. • Partner with Compliance and Credentialing teams to support audits and submissions. • Track and report key performance indicators (KPIs) such as network adequacy and provider satisfaction. • Coach and develop staff to foster a culture of accountability and continuous improvement.

🎯 Requirements

• Bachelor’s degree in Healthcare Administration, Business, or related field required; Master’s degree preferred. • Minimum 5–7 years in provider network management or contracting within a Medicare Advantage or managed care environment. • Demonstrated understanding of CMS requirements, risk-based contracting, and provider reimbursement methodologies (FFS, capitation, value-based). • Experience leading teams and managing cross-functional projects. • Excellent analytical, organizational, and communication abilities. • Proficient in Microsoft Office and provider network management tools (e.g., FACETS, HealthEdge, or similar).

🏖️ Benefits

• Health insurance • 401K plan with matching contributions • Basic and Supplemental Life Insurance • Short and Long-Term Disability • Employee Assistance Program • Wellness programs