Description

We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only).

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Veterans, Reservists, Guardsmen and military family members are encouraged to apply!

Job Summary

The Supervisor, Provider Network Management provides first-line supervision to Contract Support Specialists (CSS) who work provider contract inquiries, contract creation, and several administrative tasks. Reports to the Manager, Provider Network Management, and works under general supervision, applying policies and contractual standards independently. Escalates staffing, policy exceptions, unresolved complaints, or media/congressional inquiries to the Manager. Oversees daily operations across corporate and remote sites, including training, performance monitoring, quality audits, and staff development. Ensures the team meets contractual response times, quality standards, and provider satisfaction targets under TRICARE and VA requirements. Navigates moderate complexity from the regulated federal healthcare environment, competing service levels, TRICARE Manual and VA CCN guidance interpretation, and balancing production with empathetic communication. Interfaces with the Manager, peer supervisors, and cross-functional partners in Claims, Operations, Credentialing, Customer Service, and Provider Data. Resolves escalated provider issues and occasionally engages Defense Health Agency (DHA) or VA representatives on contract inquiries. Regular and reliable attendance is required.

Education & Experience

Required:

• Bachelor's Degree and 2 years of varied and responsible experience with health care programs, or any combination of education and experience that provides an equivalent background, plus the following:
• If supporting TRICARE contract, must be a U.S. Citizen
• If supporting TRICARE contract, must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation
• Minimum of two (2) years supervisory/management experience or demonstrated leadership skills
• Working knowledge of TRICARE and/or VA Community Care Network (CCN) provider programs, including provider contracting, claims, and reimbursement policies

Preferred:

• Working knowledge of the credentialing process and regulatory compliance standards such as URAC and JCAHO
• VA Program experience
• Three (3) years' experience in provider relations, provider contracting, or healthcare operations
• Prior experience in government healthcare delivery programs (TRICARE, VA, Medicare)
• Experience supervising remote or geographically distributed staff
• Excellent written and verbal communication skills

Key Responsibilities

• Supervises daily operations and staff for all respective functions, including maintenance and annual review of the policies and procedures.
• Train, coach, and oversee the CSS team in all aspects of the role, including conducting team meetings. Monitor individual and team adherence to service level agreements and quality standards.
• Collaborate closely with leadership and other TriWest departments to resolve cross-functional issues, identify process improvements, and escalate unresolved systemic issues to management.
• Maintains relationships with Network Subcontractors in state/market of operations.
• Establish and maintain positive working relationships with internal stakeholders and external network providers, responding to provider inquiries with professionalism, empathy, and accuracy.
• Support and manage the maintenance of accurate provider contact records in the Provider Services data systems, ensuring data integrity and compliance with documentation standards.
• Develop job aids, work instructions, processes, and procedures to support CSS consistency and onboarding of new staff.
• Monitor team production, quality, attendance, and adherence to contractual response times. Produce regular reports and dashboards for the Manager, Provider Network Management summarizing team performance against established metrics.
• Perform quality audits of CSS work to ensure staff are following established processes, communicating professionally, and responding timely. Provide constructive, documented feedback to support individual performance improvement.
• Engage in regular staff development activities, including at least monthly one-on-one meetings with each CSS and ongoing training aligned to contractual, regulatory, and operational changes.
• Provide mentoring, recognition, and coaching, and work collaboratively with staff to establish individual and team goals aligned with departmental objectives.
• Develop appropriate performance improvement plans, in collaboration with the Manager and Human Resources, when CSS staff are not meeting performance expectations.
• Supervise CSS staff based in Phoenix and remotely. Monitor productivity, quality, and quantity of work performed by each staff person and the team.
• Lead or participate in work projects and groups assigned by leadership, as well as other duties as assigned.
• Attend meetings or functions outside of normal business hours.
• Regular and reliable attendance is required.

Competencies

Coaching / Training / Mentoring: Actively foster actions required for desired business outcomes through ongoing constructive feedback.

Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapt to different styles; listen critically; collaborate.

Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.

Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required.

Empathy / Customer Service: Customer-focused behavior; helping approach, including listening skills, patience, respect, and empathy for another's position.

Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.

Information Management: Ability to manage large amounts of complex information easily, communicate clearly, and draw sound conclusions.

Leadership: Successfully manage different styles of employees; provide clear direction and effective coaching.

Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues.

Technical Skills: Working knowledge of provider contract support functions and provider data systems; proficient with Word, Excel, and Provider Services data systems, with the ability to produce reports through querying; working knowledge of VA policies and procedures outlined in the VA Operations Manual, VA Policy Manual, DoD Regulations, and applicable TRICARE contract requirements.

Working Conditions

Working Conditions:

• Availability to cover any work shift
• Works within a standard office environment, with moderate travel
• Extensive computer work with prolonged sitting

Company Overview

Taking Care of Our Nation's Heroes.

It's Who We Are. It's What We Do.

Do you have a passion for serving those who served?

Join the TriWest Healthcare Alliance Team! We're On a Mission to Serve®!

Our job is to make sure that America's heroes get connected to health care in the community.

At TriWest Healthcare Alliance, we've proudly been on that important mission since 1996.

DoD Statement

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Benefits

We're more than just a health care company. We're passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:

• Medical, Dental and Vision Coverage
• Paid time off
• 401(k) Retirement Savings Plan (with matching)
• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
• Tuition reimbursement
• Paid volunteer time

TriWest job postings typically include a salary range, which can vary based on the specific role and location, but generally this position ranges from around $64,000 - $75,000 per year.

Equal Employment Opportunity

TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that supports diversity at every organizational level, and we highly encourage candidates from all backgrounds to apply. Applicants are considered for positions based on merit and without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.