PROVIDER RELATIONS & QUALITY PERFORMANCE SPECIALIST

Company: Network Medical Management Inc
Location: El Monte
Posted on: January 12, 2022

Job Description:

SummaryThe Provider Relations Specialist is responsible for field and office activities in providing education and supporting the APA ACO providers network. The Provider Relations Specialist will be working with contracted providers on APA ACO/DCE operations and to comply with APA ACO/DCE and Medicare standards.An individual with at least two (20 years' experience in managed care in handling provider network scope of services. The individual must have an understanding of Managed Care Operations (i.e., Quality, HEDIS, HCC, etc.).Essential Duties and Responsibilities include the following:Maintain professional etiquette at all times, especially when working with Providers.Must be able to have effective interaction with providers.Ensures that providers are well-informed and educated with respect to ACO/DCE policies, procedures, and workflows as to optimize patient care and provider satisfaction.Responsible for New Provider and office staff orientations and continued education of existing providers to ensure company programs and imitative and process is being effectively communicated.Ensure provider is effectively utilizing company to0ols available to them.Must be able to problem solve and identify ways to address provider issues effectively.Develop collaborative relationships with Doctors and Office staff.Highly motivated and able to work with multiple teams simultaneously.Must be able to travel frequently to assigned service area.Other duties assigned by department Manager.Qualifications:To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Education and/or ExperienceMinimum of two (2) years customer service, provider services or relevant work experience in a healthcare setting.Excellent oral and written communication skills.Detail oriented and possess strong organizational skills in a fast-pace environment.Proven in MS office programs (i.e., Excel, Word, Outlook and Powerpoint).#LPIND

Keywords: Network Medical Management Inc, El Monte , PROVIDER RELATIONS & QUALITY PERFORMANCE SPECIALIST, Other , El Monte, California