Provider Relations Liaison
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Job Location:
Houston, MS - USA
Monthly Salary:
Not Disclosed
Posted on:
7 hours ago
Vacancies:
1 Vacancy
Job Summary
We are searching for a Provider Relations Liaison The Health Plan - someone who works well in a fast-paced managed care this position youll plan direct and maintain strategies that assure harmonious relationships are established and maintained with physicians and other providers and efficient effective care is delivered within a discreet assigned territory. Additionally youll educate providers through in-service programs that review policies and procedures physicians are obligated to adhere to discuss physician feedback as necessary and promote continuing education classes and other educational programs that support the goals and objectives of the health plan.
Think youve got what it takes
Job Duties & Responsibilities
Develops and maintains strong business relationships with participating providers
Responsible for development of a regional territory inclusive of provider selection and satisfaction as well as member growth and medical loss ratio
Resolves managed-care issues and/or problems related to claims medical management or member services issues
Identifies educational needs within the provider network and initiates educational efforts as needed or upon providers request
Develops and follows territory strategic plan aligned to our organizational mission and vision
Conducts territory assessment and develops strategic plan for service area based including interventions to meet growth projections of membership and influence medical loss ratio
Assures that monthly and quarterly mailings to providers are completed according to departmental policies and procedures
Assures that new providers receive a provider handbook within five (5) days of being added to plans
Creates Community and Provider Satisfaction
Represents Provider Relations at various meetings both internal and external
Creates community outreach opportunities for marketing and educational purposes within territory
Ensures appropriate and thorough resolution of provider issues.
Delivers exceptional service to participating providers in assigned geographic region
Supports Regulatory and Operational Compliance
Submits provider visits reports in accordance with departmental policies and procedures meeting weekly with manager
Completes assigned projects including provider accessibility survey after hours surveys satisfaction surveys newsletters and updates to provider handbooks in a timely manner
Ensure timely completion of all team projects assignments and job duties Develop project plans for team projects and assignments and serves as Team Leader for various special projects as assigned by applicable Manager
Qualifications & Requirements
High School Diploma/GED or Bachelors degree preferred (In Health Care Business or related field)
A minimum of three (3) years of health care or managed care experience
Key Skills
- Presentation Skills
- Time Management
- Clinical Research
- Communication skills
- GCP
- Infusion Experience
- Managed Care
- Hospice Care
- Conflict Management
- Clinical Trials
- Research Experience
- Home Care
About Company
Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades suc ... View more
