Sr Provider Relations Liaison - Comm. Network Operations - Pearland Admin Office - Kelsey Seybold Clinic
About The Position
Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation’s leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together. The Senior Provider Relations Liaison is responsible for establishing and maintaining solid positive business relationships with current and potential Kelsey-Seybold and KelseyCare Advantage affiliate and employed providers to ensure stable and geographically disperse networks for the Kelsey-Seybold commercial and Medicare Advantage health plans and KS Plan Administrators’ health plan products. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Requirements
- 5+ years of professional level experience in clinic or healthcare operations
- CPT and ICD-10 coding and prior experience with reimbursement methodologies
- Proven knowledge of claims processing, clinic operations, managed care plan benefits and utilization management policies and procedures
- Network development and/or provider relations experience
- Microsoft Word and Excel experience
- Proven analytical and problem-solving skills; ability to communicate effectively in writing and verbally
- Proven public speaking and presentation skills
- Valid Texas Driver’s License and ability to travel
- Own or lease a working vehicle and be able to travel daily within the Greater Houston area
Nice To Haves
- 5+ years of experience in applicable healthcare administrative operations
- 3+ years of experience in Medicare/Commercial products
- Ability to interpret provider contracts and regulatory contracts
- Experience with the development of provider relations and/or clinical networks
- Ability to work in a fast-paced environment; demonstrated ability to perform multiple concurrent tasks with minimal supervision and meet deadlines
- Proficiency with Excel and/or PowerPoint
- Excellent communication and relationship development skills with multiple different types of stakeholders. Outcomes driven
- Capable of managing a variety of complex issues while driving momentum of key projects
Responsibilities
- Providing educational instruction and support to physicians and their staff
- Be the main point of contact for the respective providers and will routinely visit physician’s offices for issues concerning the achievement of quality outcomes, provider satisfaction, medical cost targets, network growth and/or efficiency targets
- Responsibility for education of the physicians and office staff on health plan products and benefits, policy and procedure for multiple managed care plans, assistance with claims payments and other duties as assigned
- Travel requirements – local and extensive
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
