Job Details

Inspire health. Serve with compassion. Be the difference.

Job Summary

Accountable for the overall client/member services, communications, and engagement of the provider/physician practices in the region and is the direct interface between the Clinically Integrated Network (“CIN”) and assigned provider/physician practices. Acts as a liaison between network leadership and the providers so that both, in unison, are meeting the goals of the organization. Involved in the continuous process of development and education of providers and staff as it relates to goals, policies, and procedures defined by the network.

Essential Functions

• All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference.
• Serves as a liaison with the network's provider partner/member organization(s) and meet with key leaders at partner/member organizations.
• Develops and coordinates all new and continuing provider relations training and education.
• Forges relationships with providers interested in participating with the network.
• Manages and coordinates network provider site visits.
• Develops and implements a provider relations communication plan to ensure the development of newsletters, informational materials, news releases, instructional materials, and website content.
• Responds to and resolves questions or concerns from providers or their office staff in a timely and service-oriented manner
• Assesses physician performance and make recommendations in collaboration with the care model committee for corrective action.
• Assists with the administration of all provider/facility contracts to ensure network contracts meet all regulatory, payer, and accreditation requirements.
• Communicates provider manuals (including policies and procedures) appropriate to the network.
• Performs other duties as assigned.

Supervisory/Management Responsibilities

• This is a non-management job that will report to a supervisor, manager, director or executive.

Minimum Education

• Education - Bachelor's degree
• Experience - Five (5) years experience in either healthcare provider or health plan setting. Experience in a physician led hospital organization, managed care, or related setting preferred.

In Lieu Of

• NA

Required Certifications, Registrations, Licenses

• NA

Knowledge, Skills and Abilities

• Regional traveland flexibility with extended hours
• Organizational, prioritizing and planning skills as well as reporting and tracking skills
• Oral and written communication skills with all levels of staff and clients as well as strong customer service, communication, and negotiation skills
• Working knowledge of health care procedural and diagnostic billing codes (e.g., CPT, HCPCS, and ICD-9-CM) preferrered

Work Shift

Day (United States of America)

Location

Prisma Health Corporate Office

Facility

7002 Value-Based Care and Network Services

Department

70029244 Network Admin Services-Upstate

Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.