Provider Relations Specialist

Nevada System of Higher Education

176d • $35 - $54

About The Position

Under the supervision of the Vice President, Physician Engagement and Value-Based Care Performance, this position is responsible for the Endeavor Health Physician Partners (EHPP) provider relations/provider liaison activities, which include dissemination of information and education related to clinically integrated network (CIN) contracts, sharing of practice and provider level performance data, maximizing incentive revenues, provider issue resolution, and general liaison activities with network providers.

Requirements

• Bachelor's degree in health administration, public health, business administration or other related field.
• Minimum 2 years of experience in managed care, value based care, clinical integration or provider relations.
• Experience working with physicians and practice managers in an ambulatory setting.

Nice To Haves

• Demonstrated strong leadership, communication, project management (formal or informal) and team building skills.
• Excellent communication skills and the ability to present oneself and/or ideas with clarity.
• Strong analytical, problem-solving and decision-making skills.
• Excellent organizational skills and the ability to work at all levels of the organization.

Responsibilities

• Serves as a primary interface to translate issues raised by EHPP network providers, subcontractors, and vendors to actionable matters for resolution.
• Oversees the resolution of payor specific claim related issues by working with the providers and payor to identify the issue.
• Works collaboratively with network providers to facilitate and coordinate success under the EHPP payor agreements.
• Obtains provider level data to share with providers related to their performance under value-based agreements.
• Provides education and communication to physicians, managers, and staff regarding contractual obligations and operational components of value-based agreements.
• Travels to and between various EHPP locations and offices as needed.
• Supports timely distribution of pertinent information to key stakeholders and network providers.
• Actively educates EHPP network providers and monitors compliance with the clinical integration technology infrastructure requirements.
• Facilitates implementation of technology solutions within EHPP physician offices.
• Functions as a resource for questions related to basic CI technology questions.
• Works with and guides practices in meeting requirements related to payor and/or regulatory programs.
• Supports the CIN committee and governance structure as needed.
• Maintains knowledge of current trends and developments in value-based care.
• Assists with EHPP provider contracting and provider onboarding activities.
• Maintains appropriate databases, interprets and analyzes physician statistical information, and provides relevant progress reports.
• Supports incentive compensation distribution by tracking compliance with core requirements.

Benefits

• Career Pathways to Promote Professional Growth and Development
• Various Medical, Dental, Pet and Vision options
• Tuition Reimbursement
• Free Parking
• Wellness Program
• Savings Plan
• Health Savings Account Options
• Retirement Options with Company Match
• Paid Time Off and Holiday Pay
• Community Involvement Opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Bachelor's degree