Provider Network Liaison

*Provider Network Liaison* * *Only open to candidates residing in California* * *Opportunity to make a difference in your community* * *Position not eligible for sponsorship* *General Description* We are looking for a motivated, mission driven Provider Network Liaison to coordinate and facilitate initiatives that include provider learning collaboratives and the implementation and maintenance of advanced payment models to support the triple aim of healthcare: population outcomes, member’s experience of care, and financial stability.
*Position overview* _*Provider Engagement and Recruiting*_ * Develop and maintain an understanding of provider operations and provider priorities, for the provider specialty areas or provider groups assigned to you.
* Facilitate internal and provider outreach and develop communication materials to support provider learning collaboratives.
* Independently develop and maintain relationships with providers and providers’ office staff.
* Contribute to provider recruitment efforts to support network development programs, including scheduling and conducting provider visits, clearly communicating the benefits of working with HPSM, tailored to specific providers or provider types and documenting, summarizing and reporting information learned from provider visits about provider needs.
_*Provider Education and Process Improvement*_ * Produce and disseminate clear information and reporting dashboards to educate and engage providers and internal staff about payment models, provider contracts, and HPSM provider program requirements.
* Independently conduct online webinars and in-person workshops to familiarize providers with HPSM procedures and processes.
Conduct individual provider follow up as needed.
* Coordinate activities among multiple clinical settings and stakeholders using a strong project management toolkit to achieve program goals.
* Analyze needs and provide recommendations about ways to incentivize and improve member health outcomes.
* Support HPSM Quality initiatives by encouraging provider participation and offering provider education when needed.
* Contribute to ongoing process improvement by developing and/or implementing Provider Services processes to support program and department goals.
* Stay current with DHCS, CMS, and DMHC policy updates and changes.
_*Provider Issue Resolution*_ * Diplomatically and creatively resolve escalated or complex provider issues using strong professional judgment and discretion such as provider payment disputes, authorization concerns and member issues.
* Serve as a department contact regarding provider grievances, working independently to elicit provider responses in a timely manner and performing root cause analysis to reduce future potential grievances.
* Professionally represent Provider Services/HPSM in internal and external meetings.
*Requirements* These are the qualifications typically needed to succeed in this position.
However, you don’t need to meet every requirement to apply.
*Education and experience* * Bachelor’s degree in health-related field or similar, strongly preferred.
* Two (2) to three (3) years experience in insurance, healthcare, or related field required.
* Experience working with healthcare providers strongly preferred.
* Demonstrated experience utilizing process improvement methodologies, marketing and communication principles and conflict resolution techniques.
* Must have own vehicle and valid driver’s license with proof of insurance in conformity with state law minimums.
*Knowledge of:* * Knowledge of Population Health Management principles and Value-Based Payment methodologies.
* Knowledge and understanding of Managed Care, Medi-Cal and Medicare.
* Analytical approach to problem solving, conducting comprehensive research, and clearly communicating outcomes.
* Exceptional skills in establishing cooperative working relationships with internal staff and external stakeholders.
* Ability to communicate easily and effectively with individuals, large groups and senior provider leadership both verbally and in writing.
* Initiative to be proactive, work independently and use good judgement in making sound decisions.
* Ability to manage multiple priorities and meet deadlines under sometimes stressful situations calmly and effectively.
* Demonstrated proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, and PowerPoint.
*Ability to:* *Salary and benefits* *The starting salary range *depends on the candidate’s work experience.
*Excellent benefits package* includes: * HPSM-paid premiums for employee’s medical, dental and vision coverage (employee pays 10% of each dependent’s premiums) * Fully paid life, AD&D and LTD insurance * Retirement plan (HPSM contributes equivalent of 10% of annual compensation) * 13 paid holidays a year, 12 paid sick days a year and paid vacation starting at 16 days a year * Tuition reimbursement plan * Employee wellness program _Health Plan of San Mateo (HPSM) is a local County-funded nonprofit that manages the health care for over 140,000 low-income people San Mateo County, including all its Medi-Cal eligible residents.
HPSM is proud to be an Equal Opportunity Employer and an affirmative action employer.
We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status.
_ Job Type: Full-time Pay: $81,413.
00 - $107,872.
00 per year Benefits: * Dental insurance * Employee assistance program * Employee discount * Flexible schedule * Flexible spending account * Health insurance * Life insurance * Paid time off * Parental leave * Referral program * Retirement plan * Tuition reimbursement * Vision insurance Schedule: * Monday to Friday Application Question(s): * Please do not apply unless you reside in California Work Location: Remote