Provider Relations Manager / Clinical Integration
About The Position
Represents the Clinical Integration Network (CIN) and is responsible for facilitating all facets of the provider/practice relationship with the CIN. Communicates expectations of CIN membership to the provider/practice and provides direct and indirect support to the provider/practice to meet these expectations and reach shared quality goals. Ensures the administrative as well as clinical needs of the provider/practice are identified and addressed. The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization. With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.
Requirements
- Minimum: Bachelor's degree or equivalent combination of education, training and relevant experience in lieu of degree
- Minimum: 3-5 years’ experience in practice or health care related operations.
- English Language Skills
- Ability to support practice changes to discrete and varied audience i.e. Administrators, practice managers, clinicians as needed
- Proficient in Excel, PowerPoint, Access.
- Excellent communication, analytical, presentation and interpersonal skills
- Ability to understand and convey complex information to many difference kinds of people is an absolute requirement with demonstrated ability to work as a member of a team
- Competence in quality improvement and data interpretation
- Familiarity with case management and care coordination processes; experienced and skilled in working with interdisciplinary teams
- Ability to innovate to achieve the organization’s goals
- Comfortable using and/or learning to use databases, reporting software, electronic medical record
- Exhibits leadership in demonstrating to staff how to embody the patient-centered goals of the organization, and in embracing change, where appropriate
Nice To Haves
- Preferred\: Bachelor's degree in health care related field
- Preferred\: 5-7 years’ experience in practice or health care related operations including dealing with physician performance and quality reporting.
- Experience with Tableau highly preferred.
- Experience with electronic medical records (Athena, EClinical Works, AllScripts, Epic etc) preferred.
- Experience with hospital systems (Cerner, Sunrise, Epic and Premier) is preferred.
Responsibilities
- Creates and fosters relationship with assigned provider/practice to establish self as recognized liaison between CIN and provider/practice.
- Educates provider/practice on all relevant topics to promote provider/practice ability to be successful and reach shared quality goals. Topics include but are not limited to\: CIN processes/procedures, CIN incentive program details, payer initiatives, quality definitions and goals
- Provides direct support to provider/practice to assist with and resolve service issues, including but not limited to payment, authorization eligibility and member matters
- Assesses each provider/group, at a minimum annually, to determine engagement, evidence of infrastructure to perform as a CIN member, and ability to meet shared goals
- Based on annual assessment, works with provider/practice to implement action plan to mitigate identified gaps
- Provides concrete reports as well as data analysis to provider/practice to assist them in successfully meeting shared quality goals roll out and sustain practice improvement programs
- Illuminates best in class practice improvement programs and assists provider/practice in implementing these programs to meet shared quality goals
- Tracks and trends provider/practice performance to identify areas of opportunity, creating action plans to reach opportunities
- Partners with Risk Coding and Care Management to ensure alignment around provider/practice performance and communication
- Performs all other duties as assigned
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What This Job Offers
Job Type
Full-time
Career Level
Manager
