Hybrid Provider Services Supervisor - Community Health Care at Polk County BoCC

PROVIDER SERVICES SUPERVISOR - COMMUNITY HEALTH CARE

SALARY 

PG 21, $2,593.60 Biweekly, $67,433.60 Annually, Exempt

WORK LOCATION AND SCHEDULE

2135 Marshall Edwards Dr. Bartow, FL 33830

Monday - Friday, 8:00AM - 5:00PM

EMPLOYEE BENEFITS

•    Direct Deposit, Bi-Weekly Pay Checks
•    Medical, Dental, Vision
•    Life Insurance
•    FRS Retirement
•    10 Paid Holidays
•    Paid Time Off
•    Tuition Reimbursement
•    Education Incentives
•    Deferred Compensation Plan
•    Wellness Incentives
•    Employee Assistance Program (EAP)
•    Free Employee Gym
•    Free Employee Health Clinic

Must have the physical, developmental and mental ability to perform job tasks, work efforts, responsibilities and duties of the job illustrated below:

MAJOR FUNCTION

The Provider Network Manager is responsible for managing a comprehensive network of contracted healthcare providers to ensure access and continuity of care for members of the Polk HealthCare Plan. This position leads contract negotiation, implementation, and maintenance of medical service agreements while developing provider recruitment and retention strategies. The role also serves as the liaison between community healthcare providers and Plan management, driving process improvement and standard operating procedures for the network.

ILLUSTRATIVE DUTIES

Provider Network Development & Management

• Strategically recruits healthcare providers based on data-driven analysis of service gaps and underserved populations.
• Implements provider touchpoint mapping and tracks provider capacity, ensuring accessibility and service availability.
• Conducts provider site visits and maintains required visitation schedules.
• Builds and sustains professional rapport with primary and specialty care providers.

Provider Communication & Engagement

• Develops and implements provider communication strategies and annual education plans.
• Coordinates and delivers provider in-service orientations, training sessions, workshops, and seminars.
• Travels within Polk County to engage providers and their staff, address concerns, and promote open communication.
• Conducts outreach and presentations for potential provider recruitment efforts.

Network Operations & Support

• Manages provider directories and ensures accurate and timely distribution to members and providers.
• Investigates and resolves provider and member complaints, grievances, and appeals in a timely manner.
• Monitors trends in grievances and prepares detailed reports on a regular basis.

Data Reporting & Contract Compliance

• Tracks recruitment efforts, contract status, and provider availability by specialty and geographic area.
• Reviews new regulatory requirements and modifies contract templates to ensure compliance.
• Addresses issues involving non-contracted providers and facilitates resolutions.
• Serves as a liaison to cross-functional teams to ensure operational alignment.

Process Improvement & Leadership

• Develops, reviews, and updates standard operating procedures to enhance network performance.
• Participates in regular team meetings to address provider-related challenges.
• Consults with leadership on day-to-day operations and provides strategic recommendations.
• Supervises and trains assigned staff to ensure performance standards are met.

KNOWLEDGE, ABILITIES AND SKILLS

Knowledge of:

• Healthcare industry operations including provider recruitment, retention, and health plan functions.
• Local, state, and federal healthcare regulations, including HIPAA compliance.
• Supervisory principles and confidentiality standards.

Skills in:

• Analyzing healthcare market data and identifying recruitment strategies.
• Investigating complaints and applying critical thinking for resolution.
• Effective written and verbal communication for diverse audiences.
• Use of Microsoft Office applications (Word, Excel, PowerPoint) and learning specialized software.

Ability to:

• Solve problems and evaluate complex challenges to recommend practical solutions.
• Manage multiple priorities under pressure and meet deadlines independently.
• Establish and maintain professional relationships with internal teams and external partners.
• Interpret healthcare regulations and apply them to network operations.
• Deliver presentations and represent the organization in community and professional forums.
• Recognize potential issues and proactively address them.
• Maintain professionalism, discretion, and integrity at all times.
• Travel throughout Polk County and work extended hours as needed.
• Understand organizational systems and the role of community health care in county government.

MINIMUM QUALIFICATIONS

Graduate of an accredited four-year college or university with major coursework in business, healthcare administration, marketing, public relations, or a related field; and, have a minimum of five years’ experience in managed care operations and/or provider network recruitment/contracting; or, have a two-year degree in equivalent coursework and a minimum of seven years’ experience in managed care operations and/or provider network recruitment/contracting.

Must have a minimum of four years supervisory experience. 

Must have a valid driver’s license and/or be able to secure a valid Florida driver’s license at the time of employment.

An equivalent combination of education, training, or experience that is directly related to the duties of this position may be substituted for the stated minimum qualifications, except for required licenses or certifications.

PREFERRED QUALIFICATIONS

• Demonstrated knowledge of the Polk County provider community.
• Experience with provider enrollment and credentialing, contracting, medical claims, and billing methodologies.
• Experience with governmental managed care plans and reimbursement methodologies, i.e., Medicaid, Medicare.

SPECIAL REQUIREMENTS

Must undergo a Level 2 (FDLE) screening submitted electronically before commencing work. Certification must be maintained as a condition of employment.

Must be willing to work beyond normal hours when necessary. During times of impending or declared disasters (e.g., hurricanes, tornadoes, flooding), the incumbent will be expected to participate in the Polk County Emergency Management Plan, which may require extended absences from home. All employees will be required to work before, during, or after an emergency. During an emergency, employees may temporarily be assigned to work and perform duties outside the normal scope of their position, location and work schedule to fit the needs of the County and its citizens.