Provider relations & medicaid network development manager | memphis, tn | $78,000+ bonus

Salary:

Starting at $78,000+ based on experience

Bonus Opportunity:

Performance-based incentives available

Location:

Memphis, TN

Industry:

Home Care / TennCare / Medicaid Managed Care

About the Opportunity

We are seeking an experienced healthcare professional with established relationships within Tennessee Medicaid (TennCare), managed care organizations (MCOs), provider networks, Long-Term Services and Supports (LTSS), or Home and Community Based Services (HCBS). This role is ideal for candidates currently working in Provider Relations, Network Development, Case Management, Care Coordination, Community Relations, LTSS, HCBS, Managed Care, or Healthcare Business Development who are interested in joining a rapidly growing home care organization and helping expand referral partnerships throughout Memphis and West Tennessee.

We are particularly interested in candidates with experience working for or alongside BlueCare Tennessee, UnitedHealthcare Community Plan of Tennessee, Wellpoint (formerly Amerigroup), TennCare, or other organizations serving Tennessee Medicaid members. These are the primary TennCare managed care organizations serving West Tennessee, including Shelby County.

Position Overview

The Provider Relations & Medicaid Network Development Manager will be responsible for developing relationships with referral sources, TennCare managed care organizations, case managers, care coordinators, hospitals, discharge planners, community organizations, and other healthcare partners throughout Memphis and surrounding West Tennessee communities. This position combines office-based operational responsibilities with community outreach and relationship development. The individual will work closely with leadership to increase referrals, strengthen relationships with TennCare MCOs and community partners, identify opportunities for network growth, and support the continued expansion of home care services throughout the Memphis market.

Key Responsibilities

• Develop and maintain relationships with TennCare managed care organizations, provider networks, and referral partners
• Build relationships with BlueCare Tennessee, UnitedHealthcare Community Plan of Tennessee, Wellpoint, and other TennCare-related organizations
• Establish relationships with MCO case managers, care coordinators, provider relations representatives, and network development teams
• Develop referral relationships with hospitals, rehabilitation facilities, skilled nursing facilities, physicians, social workers, discharge planners, and community organizations
• Identify new referral opportunities and market growth initiatives throughout Memphis and West Tennessee
• Strengthen relationships with organizations serving Medicaid, LTSS, HCBS, elderly, and disabled populations
• Support network development and strategic growth initiatives
• Maintain knowledge of TennCare programs, HCBS, LTSS, and managed care initiatives
• Represent the organization at community meetings, networking events, healthcare organizations, and industry events
• Track referral activity and relationship-development efforts
• Assist leadership with strategic planning and business development activities

Preferred Background

Experience in one or more of the following:

• Provider Relations
• Provider Network Development
• TennCare / Tennessee Medicaid
• Managed Care
• LTSS (Long-Term Services and Supports)
• Home and Community Based Services (HCBS)
• Case Management
• Care Coordination
• Community Outreach
• Healthcare Business Development
• Home Care or Home Health

Medicaid Provider Relations Organizations of Particular Interest

Candidates with experience working for, contracting with, or developing relationships with organizations such as:

• BlueCare Tennessee
• UnitedHealthcare Community Plan of Tennessee
• Wellpoint Tennessee (formerly Amerigroup)
• TennCare
• TennCare Select
• Area Agencies on Aging and Disability
• Hospitals and health systems throughout the Memphis area
• Community organizations serving Medicaid, elderly, and disabled populations

Qualifications

• Healthcare industry experience required
• Experience working with Medicaid/TennCare populations strongly preferred
• Existing relationships within the Memphis or West Tennessee healthcare community preferred
• Experience with MCOs, provider networks, LTSS, HCBS, or Medicaid programs strongly preferred
• Strong communication and relationship-building skills
• Ability to develop relationships with case managers, care coordinators, healthcare providers, and community organizations
• Ability to work independently and manage priorities effectively
• Ability to travel locally throughout Memphis and surrounding West Tennessee communities for meetings, networking, and referral development
• Comfortable working both in an office environment and in the community with healthcare partners
• Valid driver's license and reliable transportation

Why Join Us

• Starting salary of $78,000+ based on experience
• Performance-based bonus opportunity
• Comprehensive medical, dental, and vision insurance
• 401(k) retirement plan
• Paid Time Off and paid holidays
• Life insurance
• Short-term and long-term disability coverage
• Mileage reimbursement for business travel
• Growing multi-state home care organization
• Opportunity to help shape the organization's Tennessee growth strategy
• Significant visibility with executive leadership
• Opportunity to build relationships throughout the Memphis healthcare community
• Meaningful impact on access to home and community-based care for TennCare members

Apply Today

If you have experience building relationships within TennCare, Medicaid managed care, provider networks, LTSS, HCBS, or the Memphis healthcare community, we would welcome a confidential conversation. We are especially interested in candidates who already have relationships with case managers, care coordinators, provider relations teams, or network development professionals at BlueCare Tennessee, UnitedHealthcare Community Plan, Wellpoint, or other organizations serving TennCare members.