Representative, Client Network Management (remote) or in-office (Southern CA (Los Angeles)

Company: Conifer Health Solutions
Location: Portland
Posted on: January 12, 2022

Job Description:

As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!

Job Summary

Accountable for a wide range of duties in support of complete and accurate client provider networks, including but not limited to, provider office trainings and visits, provider recruitment and membership maintenance and growth.

Essential Duties And Responsibilities

Include the following. Others may be assigned.
Accountable to visit on a regular and constant basis all client primary and specialty provider offices for all clients as assigned, including but not limited to, quality performance domains.
Responsible to inform provider and office manager of client notices, payor updates, and regulatory requirements, including but not limited to, review of gaps in care, encounter submission volumes, access and availability requirements.
Accountable to grow the provider network and client membership through new provider recruitment and business development opportunities. Responsible to gather and prepare presentation materials for the office visits.
Responsible to organize and conduct office managers in-service, including but not limited to, providing the quality training and education materials.
Accountable to maintain visit and activity logs of provider visits and identify and track issues raised by provider or office manager during the visit. Responsible to escalate issues to practice manager/director for tracking and issue resolution.

Supervisory Responsibilities

This position reports to the Manager, Provider Quality Performance and requires moderate degree of supervision to ensure provider visits and office manager forums occur as required and scheduled.

Qualifications

KNOWLEDGE, SKILLS, ABILITIES

Candidates that exhibit most of the following preferred qualifications will be well suited for this position. However,
2-4 years of health plan or management service organization experience in provider relations or related area
2+ years in managed care experience preferred

Education / Experience
High School Diploma or GED

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Must be able to work in a sitting position, use a computer and answer telephone
Light physical effort (lift to 10 lbs.).
The home office for this position will be located in Encino, CA.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Office Work Environment
Hospital Work Environment

TRAVEL
This position requires local travel (within 50-mile radius) at least 80% of the time.

Job: Patient Access

Primary Location: Modesto, California

Job Type: Full-time

Shift Type: Days

Keywords: Conifer Health Solutions, Portland , Representative, Client Network Management (remote) or in-office (Southern CA (Los Angeles), Executive , Portland, Maine