Provider Partnership Strategist

pacificsource; Bend (OR); Presencial; USD 120.000 - 180.000; Jornada completa

Descripción de la vacante

PacificSource seeks an experienced leader to provide strategic oversight for designated complex provider partnerships, driving operational efficiency, cost reductions, quality improvements, and better health outcomes. You will collaborate with physicians, executives, and cross-functional teams to design and execute joint initiatives and regional strategies.

The role emphasizes education for providers, analysis of performance reports, and proactive identification of improvement opportunities

Formación

• Ability to manage complex provider partnerships across multiple stakeholders.
• Experience in contracting methodologies for healthcare/LSB lines of business.
• Ability to analyze reports and translate into actionable insights.

Responsabilidades

• Oversee initiatives from partner opportunities across all lines of business.
• Provide ongoing training and high-touch support to network providers and staff.
• Collaborate with departments to deploy aligned initiatives and improve workflows.

Conocimientos

Stakeholder management

Project coordination

Training & coaching

Data analysis

Communication

Herramientas

Facets system

Descripción del empleo

Looking for a way to make an impact and help people?

Join PacificSource and help our members access quality, affordable care!

PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths.

Responsible for providing strategic oversight for designated complex provider partnerships, positively impacting operational efficiencies, cost, quality, and improved health outcomes. Work collaboratively with other PacificSource stakeholders and external partnership representatives, such as physicians, executive management, JOC work stream leaders (Quality, Health Services, IT, Analytics, Risk Adjustment, Pharmacy), and clinical/office staff, to create a plan of collaboration, implementation and success for JOC initiatives. Ensure consistency and collaboration with providers and internal stakeholders, as well as serve as a primary point of contact for JOC facilitation. This position works to build/strengthen relationships with strategic provider partners by ensuring effective education, analyzing and generating specific reports, and proactively identifying improvement opportunities that support PacificSource's strategic goals. This position also assists with the development and execution of region-specific strategies and coaching.

Essential Responsibilities:

• Manage for ongoing or to completion: initiatives, activities and projects resulting from partner and PacificSource identified opportunities, with engagement across all lines of business.
• Provide ongoing training, coaching and high-touch support to network system providers and staff toward the development and implementation of improvement activities to support process improvement from PacificSource and external partner.
• Collaborate with multiple departments to develop and deploy aligned initiatives, process improvement activities, and enhance workflows to improve provider partner satisfaction and streamline processes for better member care outcomes and service.
• Track project progress and communicate to JOC participants and other stakeholders; develop and manage JOC schedule; timelines, activities, and milestones.
• Provide direct provider support through contracting auditing, working as a liaison with internal departments to support improved processes with claims processing, facilities, group and provider set up.
• Provide education to applicable Providers on PacificSource products, administrative procedures, legislative, and compliance requirements.
• Work directly with Provider Network and other departmental leadership to advance JOC initiatives, working closely with other work stream leaders including Contracting, Health Services, Pharmacy, Analytics, IT, Population Health and Risk Adjustment.
• Work with internal stakeholders and business owners to present and review data and deliver provider reporting packages. Assist in identifying opportunities/trends, tools, and proposed course of action to help meet incentive, quality, and operational goals as appropriate.
• Work with consultants and various areas of hospital(s) - finance, clinic managers, billing supervisory staff, Utilization, Credentialing -to develop a strategic direction based off of current processes and opportunities. Create and help execute a collaborative roadmap to accomplish established goals.
• Prepare materials and presentations for meetings, with the assistance of the Provider Relations Representative, Quality Coordinator, and other applicable personnel. Conduct/participate in group operational meetings.
• Receive, analyze, and respond to provider issues and assure timely, appropriate follow-up. Work to identify potential trend issues and seek resolution(s).
• Serve as a provider contact and problem solver for a wide range of issues including, but not limited to; claims, operational, encounter, quality, risk provider, clinic, billing, health services notifications, capitation/financial, contractual details and any data/reporting needs.

Supporting Responsibilities:

• Understand contracting methodologies and terms for all lines of business.
• Proactively develop positive working relationships with other PacificSource departments and staff to resolve provider issues.
• Develop thorough knowledge of system capabilities related to Facets setup, Facets Business Support, other supporting systems.
• Exercise independent judgment and communicate effectively between internal and external team members.
• Meet department and company