United States - Nationwide
Los Angeles, California
Iowa City, Iowa
North Charleston, South Carolina
Posted: 02-Oct-24
Location: San Antonio, Texas
Salary: Open
Internal Number: 219185
Summary:
Works to ensure the contracted provider network is educated and oriented into the CHRISTUS Health Plan with operational understanding and expectations. Works in collaboration with additional operations teams to ensure the network provider has the education needed to function at the highest level with CHRISTUS Health Plan, including but not limited to, Quality, Pharmacy, and Care Management. This position is responsible for onboarding, educating, and servicing the provider contracted network. Serves as lead relationship contact for contracted providers. Plays an integral part in ensuring the contracted providers have a good network experience.
Responsibilities:
- Educate all newly contracted providers with the CHRISTUS Health Plan process
- Serve as primary contact for network providers when they have an issue needing resolution
- Develop and maintain collaborative provider relationships that facilitate provider engagement, integration, and path to value arrangements.
- Manage provider engagement/risk continuum, prospecting potential providers for value-based opportunities
- Apply network configuration and incentive - based payment models as appropriate to improve quality and efficiency
- Leverage financial and utilization data with physicians and healthcare executives to provide actionable goals and opportunities to reduce expenses for providers with a shared savings opportunity
- Facilitate clinical education, leveraging clinical experience from your internal partners
- Partner with internal stakeholders to create a seamless experience for providers Travel requirement 85%.
Requirements:
- Bachelor?s degree preferred, but not required
- Analytic ability to organize and prioritize work to meet deadlines.
- Proficient in Microsoft Word, PowerPoint, and Excel
- Excellent written and verbal skills required
- Good judgment, initiative, and problem-solving abilities
- Ability to handle and resolve complex issues with little assistance
- Ability to perform multiple tasks simultaneously
- 5 years? Experience in healthcare field provider-facing
- Prior experience working with Medicare and Commercial Payers
- Healthcare Claim Knowledge
- Presentation/Training experience
- Experience with ACO, Risk-Based, Value-Based Contracting highly desirable.
- Driver?s License
Work Type:
Full Time
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