Network Management Specialist SCMG Provider Services Sharp Corporate Day Shift Full Time

Hours:

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AWS Hours Requirement:

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Weekend Requirements:

On-Call Required:

Hourly Pay Range (Minimum - Midpoint - Maximum):

The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors including an applicants years of experience unique skills and abilities education alignment with similar internal candidates marketplace factors other requirements for the position and employer business practices.

Please Note:As part of our recruitment process you may receive communication from Dawn our virtual recruiting assistant. Dawn helps coordinate scheduling for screening calls and interviews to ensure a smooth and timely experience. Rest assured all candidate evaluations and hiring decisions are made by our recruitment and hiring teams.

What You Will Do
Professionally manages all aspects of an assigned SCMG provider region. Works closely with the physician network affiliated hospitals ancillary providers Sharp HealthCare and all departments within SCMG. Specifically recruit orient and provide ongoing service to providers and ensure provider adherence to policies and procedures of SCMG and affiliated health plans. Identifies and resolves providers issues or concerns in a timely manner. Consistently supports SCMG by maintaining a positive and professional image.

Required Qualifications

• Associates degree related field (equivalent from two-year college or technical school may substitute)
• 5 years IPA or related experience with excellent organizational oral/written communication skills and interpersonal skills.

Essential Functions

• Actively promotes improved relationships
  Responsible for maintaining and enhancing relationships with Providers (including ancillary) and office staff.
• Assist with development of marketing and public relations materials as requested for SCMG and its providers affiliated health plans hospitals or consulting groups such as newsletters or photographs of physicians
• Business development
  Develop relationships with community businesses (i.e. Senior Centers Assisted Living Homes Marketing Consulting Groups etc.) and coordinate lectures screenings and other marketing events with that business
• Collaboration and teamwork
  Oversees activities and coordinates projects with other persons within the Network Management Department to provide education and communicate information to the provider network. (i.e. Regional Council Meetings PCP council Office Manager Meetings Joint Operation Committee Meetings etc.).
• Community outreach activities
  Participate in health fairs lectures community events and other marketing events to promote IPA and its affiliated providers.
• Data collection and distribution
  Responsible for producing updating and distributing information to provider network including patient satisfaction reports Pay for Performance initiatives and QISR.
• General support
  Perform other functions as requested.
• Health education
  Coordinate and provide assistance to health plans and other clients as necessary for health education services (i.e. participate in health fairs and member orientations as needed).
• Information systems support
  Supports physicians and staff when implementing Information Technology in the provider offices. Able to demonstrate knowledge of hardware specifications and software applications. Installs trains and maintains necessary applications in provider offices. Acts as liaison between Sharp IS and provider office.
• Meeting participation
  Attend meetings as needed to provide information about IPAs policies & procedures and operations or as a departmental representative. Responsible for agenda preparation and content; records meeting minutes.
• Physician contracts
  Ability to review negotiate and comprehend physician contracts in order to respond to inquires from physicians & staff. Conducts contract analysis related to contract performance by examining appropriate claims and other applicable data.
• Problem resolution
  Act as a liaison to ensure timely problem/issue resolution between Health Plans Hospitals SCMG and Providers. Accountable as a liaison between providers and SCMG departments for successful identification and resolution of issues.
• Professional development
  Identify and participate in educational classes that will improve the relationship between SCMG and physician network.
• Reports and surveys
  Coordinate the production and dissemination of necessary reports and surveys to effectively manage assigned region.
• Training and education
  Responsible for conducting on and off-site training sessions for new and existing Providers and office staff. This includes but is not limited to education regarding contract interpretation claims coding operations reimbursement compliance issues clinical operations policy and procedures governmental regulation and technology solutions i.e. HIPPA AB1455 and Pay for Performance.

Knowledge Skills and Abilities

• Ability to read and analyze and interpret contracts general business periodicals professional journals technical procedures or governmental regulations.
• Ability to understand computer hardware and software applications.
• Ability to write reports business correspondence and procedure manuals.
• Ability to effectively present information and respond to questions from groups of managers providers and the general public.
• Ability to add subtract multiply and divide in all units of measure using whole numbers common fractions and decimals.
• Able to demonstrate specific technical knowledge related to LAN/WAN configurations and multiple practice management systems.
• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
• Ability to interpret a variety of instructions furnished in written oral diagram or schedule form.
• Must be proficient in Microsoft Office and Internet technologies.
• Must also be detail-oriented and be able to speak in front of large groups audience can range from 1 to 150 individuals.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race religion color national origin gender gender identity sexual orientation age status as a protected veteran among other things or status as a qualified individual with disability or any other protected class