Provider Relations Manager Health Plans II - Health Plan Network

CHRISTUS Health; Houston (TX); Vor Ort; USD 95.000 - 130.000; Vollzeit

Zusammenfassung

CHRISTUS Health seeks a Provider Education & Onboarding Lead to educate and onboard contracted providers into the CHRISTUS Health Plan, ensuring alignment with Quality, Pharmacy, and Care Management expectations. You will serve as the lead relationship contact and collaborate with internal teams to deliver training that enables providers to operate at the highest level with CHRISTUS.

This role requires frequent travel (up to 85%), exceptional communication, and strong organizational skills to

Qualifikationen

• Bachelor’s degree preferred.
• Proficient in Microsoft Word, PowerPoint, and Excel.
• Excellent written and verbal skills.

Aufgaben

• Onboard and educate newly contracted providers with CHRISTUS Health Plan processes.
• Serve as primary contact for provider issues needing resolution.
• Develop collaborative provider relationships to drive engagement and value-based care.
• Travel up to 85% to meet providers and deliver training.
• Organize work to meet deadlines with strong attention to detail.
• Leverage financial and utilization data with physicians and healthcare executives to identify opportunities to reduce costs and improve quality.

Kenntnisse

Communication skills

Presentations

Ausbildung

Bachelor’s degree preferred

Tools

Microsoft Word

Microsoft PowerPoint

Microsoft Excel

Jobbeschreibung

Summary:

Works to ensure the contracted provider network is educated and oriented into the CHRISTUS Health Plan with operational understanding and expectations. Works in collaboration with additional operations teams to ensure the network provider has the education needed to function at the highest level with CHRISTUS Health Plan, including but not limited to, Quality, Pharmacy, and Care Management. This position is responsible for onboarding, educating, and servicing the provider contracted network. Serves as lead relationship contact for contracted providers. Plays an integral part in ensuring the contracted providers have a good network experience.

Responsibilities:

• Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Educate all newly contracted providers with the CHRISTUS Health Plan process.
• Serve as primary contact for network providers when they have an issue needing resolution.
• Develop and maintain collaborative provider relationships that facilitate provider engagement, integration, and path to value arrangements.
• Manage provider engagement/risk continuum, prospecting potential providers for value-based opportunities.
• Apply network configuration and incentive - based payment models as appropriate to improve quality and efficiency.
• Leverage financial and utilization data with physicians and healthcare executives to provide actionable goals and opportunities to reduce expenses for providers with a shared savings opportunity.
• Facilitate clinical education, leveraging clinical experience from your internal partners.
• Partner with internal stakeholders to create a seamless experience for providers.
• There will be travel requirement 85%.
• Organize and prioritize work to meet deadlines.
• Must have good judgment, initiative, and problem-solving abilities.
• Handle and resolve complex issues with little assistance.
• Able to perform multiple tasks simultaneously and with strong attention to detail.

Requirements:

Education/Skills

• Bachelor’s degree preferred.
• Proficient in Microsoft Word, PowerPoint, and Excel.
• Excellent written and verbal skills.

Experience

• 5 years’ Experience in healthcare field provider-facing.
• Prior experience working with Medicare and Commercial Payers.
• Healthcare Claim Knowledge.
• Presentation/Training experience.
• Experience with ACO, Risk-Based, Value-Based Contracting highly preferred.

Licenses, Registrations, or Certifications

• Driver’s License required.

Work Schedule:

8AM - 5PM Monday-Friday

Work Type:

Full Time