Requisition ID: 790713
Position:Full-Time
Total Rewards: Benefits/Incentive Information

There’s more to EyeMed than meets the eye. EyeMed is the fastest growing managed vision benefits company in the country with consistent double-digit membership growth! Through our commitment to innovation, we’re reimagining the way employers and their employees think about vision care. We want them to see life to the fullest and experience more of what’s best, not more of the same. And if what’s best hasn’t been done yet, it’s our exceptional and passionate employees driving this change. But, our passion for vision isn’t just about vision insurance benefits. Our employees are proud to support and participate in life-altering global and local missions through our partnership with OneSight, a leading not-for-profit organization with a 100% focus on eradicating the world’s vision crisis.

Your family says a lot about who you are. EyeMed is a key member of the Luxottica family of companies, global leaders in the design, manufacture and distribution of fashion, luxury and sports eyewear. In North America, Luxottica is the home to global brands Ray-Ban, Oakley and many top fashion house brands. Our leading retail brands include LensCrafters, Sunglass Hut, Pearle Vision, and Target Optical.

If you’re passionate about driving innovation and change and interested in a career in the optical and insurance industry, EyeMed wants to start the conversation and help provide you a growth-focused opportunity with America’s fastest growing vision benefits company.

GENERAL FUNCTION

The Manager-Provider Relations (Network Relationship Manager) is responsible for managing relationships with providers. This role is responsible for the overall network health of an assigned region, including executing plans to align with and help drive sales strategy and responsibility for building and maintaining positive provider relationships. Key areas of focus include executing strategies to close network gaps, maximizing provider retention, increasing provider satisfaction and ensuring compliance with business and regulatory requirements.

MAJOR DUTIES AND RESPONSIBILITIES

• Understand provider strategy to partner and work with network management team to ensure alignment of EyeMed network and maintain positive relationships with the internal sales and account management team
• Conduct ongoing outreach to ensure provider satisfaction and identify issues before escalation. Work with network providers to address administrative concerns or issues, resolving escalated provider issues such as claim and billing discrepencies and credentialing issues
• Assist in the review and assessment of provider network adequacy and accessibility
• Lead effective provider onboarding and training to use our systems and claim submissions and to service our members with understanding of plan benefits and code procedures
• Partner internally to develop provider communications and training materials, complying with all marketing collateral to deliver the Provider core story
• Develop and implement appropriate network management project timelines in collaboration with sales team
• Work to build a business case to provide recommended approach for reimbursement increases. Develop and issue appropriate reporting.
• Maintain overall knowledge of state laws and regulations. Fully understand and ensure operationalization of and compliance with legislative changes as they apply to network management including contracts and processes
• Provide complete and timely communication and reporting to manager related to projects in process. Partners with and adheres to deadlines set by various functional areas.

BASIC QUALIFICATIONS

• Bachelor’s Degree or equivalent experience
• 5+ years business experience, preferably in network development, provider relations, or sales/account management in the health care field
• Ability to work independently and set agenda for area of responsibility including prioritization of work, scheduling, tasks and projects
• Ability to work constructively under pressure and think analytically in regards to operations and administrative processes
• Ability to efficiently and effectively manage the details of numerous customers simultaneously and properly set expectations with customers and follows-through on execution to completion
• Excellent verbal and written communication skills, customer service skills, and ability to maintain composure and professionalism in stressful situations
• Working knowledge of Microsoft Word,Excel

PREFERRED QUALIFICATIONS

• Knowledge and understanding of plan benefit designs, standards of administration, managed vision care and network options
• Working knowledge of private doctor community
• Ability to engage with physicians in regards to service reimbursement and negotiations

Upon request and consistent with applicable laws, Luxottica will provide reasonable accommodations to individuals with disabilities who need assistance in the application and hiring process. To request a reasonable accommodation, please call the Luxottica Ethics Compliance Hotline at 1-888-887-3348 (be sure to provide your name and contact information so that we may follow up in a timely manner).

We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, gender, national origin, social origin, social condition, being perceived as a victim of domestic violence, sexual aggression or stalking, religion, age, disability, sexual orientation, gender identity or expression, citizenship, ancestry, veteran or military status, marital status, pregnancy (including unlawful discrimination on the basis of a legally protected pregnancy or maternity leave), genetic information or any other characteristics protected by law. Native Americans receive preference in accordance with Tribal Law.