Provider Relations Representative
Medical Specialists of the Palm Beaches, Inc.
(MSPB) is a FAST GROWING primary care focused, multi-specialty physician group practice serving Palm Beach and Broward counties We pride ourselves in being a value-based, care focused, integrated healthcare delivery system committed to providing comprehensive, high-quality care with respect and integrity for its patients and the community.
MSPB has 100 providers ,more than 30 offices and offers primary care, cardiology, neurology, hematology/oncology, concierge medicine and laboratory services.
We offer a comprehensive benefits package to full-time employees.
The Provider Relations Representative develops & maintains positive relationships with physicians, providers, and practice managers within our participating provider network, including oversight & managing performance in various incentives based and/or value-based programs.
Responsible for educational needs of providers and their office staff in any matters concerning provider relationships with MSPB and network service issues.
Facilitates the development of a comprehensive provider network and serves as the primary contact, offering education, technical assistance and problem solving as necessary.
Primary
Responsibilities:
Develop & maintain positive relationships with providers, ensure provider adherence to contractual requirements, and educate providers and office staff on topics including, but not limited to health plan operations/policies and procedures, preventative & quality outcome metrics & risk adjustment.
Responsible for understanding, developing, tracking, monitoring, and reporting on key programs performance metrics, such as STARs, HEDIS, and other quality performance measures.
Prepares for and participates in meetings with providers and provider staff and plans, creates & delivers agendas and/or presentations.
Work closely with providers & office staff to encourage membership growth & member retention.
Provide follow-up and intervention relating to provider complaints, thereby ensuring that the complaint process is appropriately handled.
Provide educational updates monthly or as necessary with providers and office staff on changes within VBC.
Performs other duties as assigned.
Commitment to excellence and high standards.
Excellent written and oral communication skills.
Strong organizational, problem-solving, and interpersonal skills.
Ability to manage priorities and workflow.
Versatility, flexibility, and a willingness to work within constantly changing priorities with enthusiasm.
Proficient in Microsoft Office, Word, Excel, PowerPoint.
Ability to understand and follow written and verbal instructions.
Ability to deal effectively with a diversity of individuals at all organizational levels.
Knowledge of provider reimbursement, Medicare reimbursement, coding and HEDIS Measures and care gap reporting preferred.
Understanding of provider office dynamics and optimal approaches to communicating and educating providers and provider staff.
Personal Qualities:
Develops and maintains good relationships with co-workers.
Demonstrates good judgment when dealing with sensitive issues.
Handles interruptions and unpredictable situations.
Must demonstrate good judgment regarding confidentiality policy.
Supports organizational and department goals.
Contributes important information.
Dresses appropriately for position.
Maintains a high degree of dependability.
Education and/or Training:
High School Graduate or equivalent BA / Associate Degree preferred.
Three (3) years experience in Primary Care Healthcare One (1) year experience in customer service/relations-like roles Understanding of provider reimbursements and coinciding challenges (FFS, CPT code reimbursement, etc.
) MRA & VBC knowledge.
Physical Demands Potential travel required; 30%-50% per month.
Lifting, carrying, and setting up provider training materials - weighing up to 35 lbs.
PI226489722 Recommended Skills Agenda Development Communication Confidentiality Customer Service Education Interpersonal Skills Estimated Salary: $20 to $28 per hour based on qualifications.
(MSPB) is a FAST GROWING primary care focused, multi-specialty physician group practice serving Palm Beach and Broward counties We pride ourselves in being a value-based, care focused, integrated healthcare delivery system committed to providing comprehensive, high-quality care with respect and integrity for its patients and the community.
MSPB has 100 providers ,more than 30 offices and offers primary care, cardiology, neurology, hematology/oncology, concierge medicine and laboratory services.
We offer a comprehensive benefits package to full-time employees.
The Provider Relations Representative develops & maintains positive relationships with physicians, providers, and practice managers within our participating provider network, including oversight & managing performance in various incentives based and/or value-based programs.
Responsible for educational needs of providers and their office staff in any matters concerning provider relationships with MSPB and network service issues.
Facilitates the development of a comprehensive provider network and serves as the primary contact, offering education, technical assistance and problem solving as necessary.
Primary
Responsibilities:
Develop & maintain positive relationships with providers, ensure provider adherence to contractual requirements, and educate providers and office staff on topics including, but not limited to health plan operations/policies and procedures, preventative & quality outcome metrics & risk adjustment.
Responsible for understanding, developing, tracking, monitoring, and reporting on key programs performance metrics, such as STARs, HEDIS, and other quality performance measures.
Prepares for and participates in meetings with providers and provider staff and plans, creates & delivers agendas and/or presentations.
Work closely with providers & office staff to encourage membership growth & member retention.
Provide follow-up and intervention relating to provider complaints, thereby ensuring that the complaint process is appropriately handled.
Provide educational updates monthly or as necessary with providers and office staff on changes within VBC.
Performs other duties as assigned.
Commitment to excellence and high standards.
Excellent written and oral communication skills.
Strong organizational, problem-solving, and interpersonal skills.
Ability to manage priorities and workflow.
Versatility, flexibility, and a willingness to work within constantly changing priorities with enthusiasm.
Proficient in Microsoft Office, Word, Excel, PowerPoint.
Ability to understand and follow written and verbal instructions.
Ability to deal effectively with a diversity of individuals at all organizational levels.
Knowledge of provider reimbursement, Medicare reimbursement, coding and HEDIS Measures and care gap reporting preferred.
Understanding of provider office dynamics and optimal approaches to communicating and educating providers and provider staff.
Personal Qualities:
Develops and maintains good relationships with co-workers.
Demonstrates good judgment when dealing with sensitive issues.
Handles interruptions and unpredictable situations.
Must demonstrate good judgment regarding confidentiality policy.
Supports organizational and department goals.
Contributes important information.
Dresses appropriately for position.
Maintains a high degree of dependability.
Education and/or Training:
High School Graduate or equivalent BA / Associate Degree preferred.
Three (3) years experience in Primary Care Healthcare One (1) year experience in customer service/relations-like roles Understanding of provider reimbursements and coinciding challenges (FFS, CPT code reimbursement, etc.
) MRA & VBC knowledge.
Physical Demands Potential travel required; 30%-50% per month.
Lifting, carrying, and setting up provider training materials - weighing up to 35 lbs.
PI226489722 Recommended Skills Agenda Development Communication Confidentiality Customer Service Education Interpersonal Skills Estimated Salary: $20 to $28 per hour based on qualifications.
|
|
 | |
