Provider Network Liaison

Job Locations US-IL-Chicago
Posted Date 2 months ago(6/24/2020 11:48 AM)
Requisition ID
2020-12911
Category
Leadership
Position Type
Regular Full-Time
Shift
Days

Overview

Provides day to day support for the organizations participating in the Integrated Care for Kids (InCK) network. Works with provider practices and organizations to enhance provider/organization interactions with payors and the InCK program. Ensures that participating organizations understand the requirements of the contracts and the InCK program. Collaborates with the CIN, Healthy Communities, and Physician Services teams to achieve program and customer service goals.  Initiates programs that enhance provider/organization satisfaction and compliance with contracts and InCK programs.

Responsibilities

  1. Assist Director of Operations in marketing the InCK program and recruiting providers and organizations into the network.
  2. Serves as the primary contact for participating InCK organizations; manages and maintains communications with participating organizations; provides technical assistance; addresses questions or concerns regarding InCK programs, IT systems, contract provisions and quality improvement initiatives.
  3. Performs onboarding for new providers, practices, and organizations.  Ensures completion of necessary forms, applications and contracts required for InCK network participation.
  4. Maintains provider/organization database, oversees compliance with InCK network participation guidelines and relevant contracts. Sends notices and updates as necessary.
  5. Develops and conducts physician and staff training regarding InCK programs, IT systems, contracts and quality improvement initiatives.
  6. Communicates with InCK practices and organizations the incentive compensation structures contained in the InCK contracts. Supports participating organizations in maximizing their revenue opportunities under Medicaid.
  7. Serves as an intermediary to promote InCK value-based contracts and resolve issues on behalf of InCK practices and organizations with payors
  8. Partners with project leads, IT vendors and third-party consultants to support and facilitate the implementation of data acquisition feeds with participating InCK practices and organizations.
  9. Responsible for collaborating with practice/organization and vendor(s) to troubleshoot and resolve any data-related issues.
  10. Plays key role in monitoring and tracking established managed care and InCK contract requirements and develops internal reporting and analysis regarding compliance.
  11. Conducts regular site visits and attends meetings with InCK network organizations and community stakeholders to pursue and maximize opportunities to enhance and support growth of InCK program and network
  12. Performs job functions adhering to service principles with customer service focus of innovation, service excellence and teamwork to provide the highest quality care and service to our patients, families, co-workers and others.
  13. Other duties as assigned

Qualifications

  1. Bachelor's degree required.
  2. Minimum of 2 years’ experience working in a healthcare environment, Medicaid managed care setting and/or strong community organization experience working with community-based organizations (schools, churches, day care providers, etc.)
  3. Understanding of performance improvement, the business of health care, and integration of care across the continuum preferred.
  4. Ability to develop strong working relationships with affiliated physicians and organizational leadership.
  5. Strong customer service acumen, both internal and external. Ability to function well individually, as well as in teams.
  6. Strong verbal and written communication skills
  7. Strong computer skills; Microsoft and other applications.
  8. Ability to handle multiple projects simultaneously.
  9. Ability to develop educational material and create reports.
  10. Strong communication and organizational skills. Excellent prioritization, coordination and time management skills.
  11. Local travel required; ability to attend evening meetings required.

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