Enlightened, Inc · 6 days ago
Manager, Provider Network & Basic Health Plan Implementation
Washington, DC, US
Full-time
Onsite
Senior Level
$115K/yr - $135K/yr
5+ years expEnlightened, Inc is seeking an experienced Manager, Provider Network & Basic Health Plan Implementation to lead the strategic execution and operational rollout of the Basic Health Plan within the provider network. This role involves overseeing provider onboarding, managing project plans, and ensuring compliance with health plan standards while fostering a results-driven team culture.
Information Technology
Responsibilities
Lead end-to-end implementation of the Basic Health Plan across the provider network
Develop and manage project plans, timelines, and deliverables with internal and external stakeholders
Oversee provider onboarding, contracting, and integration processes specific to the BHP
Serve as the primary liaison between provider organizations and internal departments to ensure alignment and compliance
Monitor provider performance metrics to ensure adherence to health plan standards and regulatory requirements
Collaborate with compliance and quality teams to address performance gaps and implement corrective actions
Identify opportunities to streamline workflows and enhance provider engagement
Contribute to strategic planning initiatives for network expansion and program optimization
Facilitate communication with state agencies, health plan partners, and provider organizations
Prepare reports, presentations, and updates for executive leadership and regulatory bodies
Provide mentorship, performance management, and professional development to direct reports
Foster a collaborative, accountable, and results-driven team culture
Use advanced Excel skills to analyze provider data, track implementation progress, and generate actionable insights
Create dashboards, models, and reports to support strategic decisions
Qualification
Required
Bachelor's degree in healthcare administration, public health, business, or a related field (Master's preferred)
5+ years of experience in provider network management, health plan operations, or healthcare project implementation
Demonstrated leadership experience with a track record of managing teams and achieving results
Strong knowledge of Medicaid, Basic Health Plans, and provider contracting
Expert-level proficiency in Microsoft Excel (pivot tables, formulas, and data visualization)
Excellent communication, negotiation, and stakeholder engagement skills
Preferred
Experience working with state health agencies or managed care organizations
Familiarity with value-based care models and provider performance analytics
Proficiency with project management tools and healthcare data systems
Benefits
Medical/Dental/Vision Insurance with Health Savings Accounts (HSA)
Flexible Spending Accounts (FSA)
401(k) Retirement Plan
Paid Holidays, Vacation, & Sick Leave
Professional Training & Development Reimbursement
Company
Enlightened, Inc
Enlightened, Inc. is an award-winning, information technology (IT) consulting firm headquartered in Washington, DC.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Antwanye Ford
Co-Founder, CEO & President
Recent News
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2023-09-13
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2022-09-08
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