Associate - Provider Partnership

 About the company:
Our client is into health care. Provide access to high quality healthcare, innovative programmes and a wide range of health solutions that help families and individuals get well, stay well and be well. 

Responsibilities:
  • Perform initial health plan orientation and conduct ongoing educational outreach with a focus on improving quality and financial outcomes within provider network
  • Conduct initial provider orientations as well as ongoing educational outreach
  • Educate providers regarding policies and procedures related to referrals, claims submission, website education, Electronic Health Records, Health Information Exchange, and Electronic Data Interface.
  • Engage providers on Patient Centered Medical Home initiatives.
  • Perform detailed HBR (Health Benefits Ratio) analysis and create reports for provider.
  •  Review provider performance by both quantitative metrics and qualitative factors.
  • Create and communicate milestone documents, dashboards and success metrics.
  • Act as a liaison between the provider and the health plan ensuring a coordinated effort in improving financial and quality performance. 
  • Provide status updates for providers regarding incentive agreements. 
  • Conduct site visits when required and other Contracting duties as requested.
  • Ability to travel.

Qualifications:

  • Education:  
  • Bachelor’s Degree in related field or equivalent experience
  • Advanced knowledge of Microsoft Excel.

  • Experience:. 
  • 3 + years of combined managed healthcare and provide reimbursement experience. 
  • Clinical or health information management (HIM) experience preferred.
 

  • Current state driver’s license.


Our client and us gives is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Employee Status:

Regular

Job Level:

Staff

Job Type:

Regular 


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