Sr Provider Relations Liaison Comm. Network Operations Pearland Admin Office Kelsey Seybold Clinic

Kelsey-Seybold Clinic • Brookside Vl, TX

2d

About The Position

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.

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

• Responsibilities include 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 and 401k contribution

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees