Job Summary:
The Provider Relations Specialist works in collaboration with physician practices with opportunities for improved performance and provides practice physicians and staff with assistance and guidance in quality reporting. Provides support for the member practices to meet quality and efficiency goals through optimizing practice workflow and a focus on patient engagement. Must possess the ability to work independently with strong organizational, communication, and interpersonal skills to support the management of multiple priorities, at multiple locations, with significant attention to detail for completion of verbal and written communications. May perform quality audits as needed. This position is non-exempt.
Duties & Responsibilities:
- Serves as a primary point of contact with both internal and external contacts to facilitate the smooth flow of information to coordinate improvement efforts related to quality and efficiency performance.
- Develop and maintain an atmosphere of personalized service through individual contact with key GHPN member providers, local administrative leadership and GHPN leadership
- Provides orientation to all new contacted physicians groups within assigned territory and provides field, telephonic and electronic support to assigned providers.
- Meets with each assigned provider on a regularly recurring basis to ensure that the practice is well informed of the major GHPN strategies and initiatives
- Serve as a resource to all staff and physicians to facilitate the member4ship process, issues resolution and all general inquires regarding member ship in GHPN.
- Actively assists with performance incentives standards, network gap closures, contract performance and other related items needed
- Responsible for coordinating and facilitating all meetings with Provider Group
- Maintain a database of meetings with physicians/offices
- Produce detailed reports identifying specific issues resolved on behalf of the members
- Assist with the coordination of regional POD meetings. Ensure all providers receive invitations to POD meetings in their regions and follow up on action items from the meeting
- Coordinate and attend activities related to physician events, CME conferences, etc.
- Monitor and track provider member concerns to ensure timely follow up and resolution
- Collaborate with other GHPN departments (care management, coding and analytics)
Educational / Experience Requirements:
- Strong Clinical background required. MA or LVN preferred.
- Three to five years nursing experience or physician relations/performance improvement experience
- Understanding of clinical assessments and treatment protocols, knowledge of principles related to quality improvement.
- Requires knowledge of managed care contractual terms and operational issues related to provider relation activities.
- Ability to utilize nursing skills to understand and coordinate care of those members that are significantly physically compromised by their illness and/or disability Excellent time management, attention to detail, organizational and communication skills.
- Demonstrated ability to manage continuous quality improvement initiatives, including the collection and analysis of data and the implementation of proposed solutions.
- Strong verbal and written communication skills and problem-solving skills.
- Requires flexibility, to be able to switch priorities in positive and effective manner when directed by leadership.
- Strong working knowledge in Microsoft Office applications, Word, Excel, Outlook and PowerPoint; EMRs/EHRs.
- Must maintain valid Texas driver’s license and vehicle and automobile insurance coverage.
Physical Demands / Working Conditions:
- Travel to member offices is mandatory
- Ability to travel by car and transport required mobile equipment
- No supervisory responsibilities
Job Type: Full-time
Pay: $58,000.00 - $61,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Experience level:
Shift:
Weekly day range:
Work setting:
Application Question(s):
- Do you have experience in Clinical operations?
- Do you have any experience related to ACO/Value Based Contracts?
- Do you have experience in working with AND supporting physicians?
- The salary range for this role is $58K - $61K, is this within your expectations?
Ability to Relocate:
- Dallas, TX: Relocate before starting work (Required)
Willingness to travel:
Work Location: Hybrid remote in Dallas, TX