Provider Network Specialist jobs in Levittown, NY

• Increase provider engagement and satisfaction
• Improve provider financial performance and cost of care goals
• Improve provider Quality performance and member health outcomes
• Facilitate provider success with HCP

• Engage directly with network providers and staff to drive population health and value based care success.
• Develop and implement continuous improvement strategies within assigned territories to increase provider engagement and performance
• Aggregate and maintain an up to date repository of provider information for assigned territories
• Proactively develop and maintain strong working relationships with assigned providers through regular onsite (and remote/telephonic) touchpoints, as required; ability to work up to 80% in the field.
• Utilize key performance data to identify provider specific opportunities and develop individualized improvement plans.
• Collaborate with office stakeholders to assess current workflows, implement best practices, and support the completion of HCP related objectives as needed.
• Collaborate with cross-functional teams to ensure successful implementation of provider performance programs and agreements.
• Develop and present materials to facilitate meaningful, value added provider touchpoints (performance opportunities, training materials, provider education, best practice workflows, etc…)  
• Review territory progress on an ongoing basis and update strategic plans to meet identified goals.
• Identify common issues affecting provider networks; collaborate with Network Relations leadership team to develop solutions.
• Promote network adoption of technology solutions (i.e. provider portal).
• Collaborate with HCP’s Quality and Medical Management teams to ensure quality assurance monitoring of PCP’s.
• Coordinate and execute internal monthly reporting and strategy 360 sessions with relevant HCP stakeholders.
• Participate in multidisciplinary teams to explore, develop, and implement new initiatives.
• Communicate and support new initiatives at the provider level.
• Aggregate provider feedback and identify ways for HCP to increase value to providers.
• Research and solve provider issues. Communicate resolutions within allocated timeframe.

• Work with Human Resources to recruit, interview, hire and employ new teammates.
• Utilize “Monday” CRM tool to ensure successful prep, execution, and follow-up of engagements (for both PNM and direct reports), identify training/coaching opportunities for direct reports, facilitate reporting at 360 sessions, and additional adhoc request.  
• Perform other duties as assigned.

• Ability to analyze data to identify and prioritize practice opportunities
• Ability to synthesize opportunities into digestible presentations and achievable plans
• Ability to interface with physicians and staff in a professional and positive manner to create alignment and achieve common objectives
• Proven ability for creative problem solving
• Strong customer service and interpersonal “soft-skills”
• Strong knowledge of primary care office operations and managed care models.
• Strong understanding of Medical Loss Ratio (MLR), HCC, Stars, HEDIS and QARR and other population health/value based KPI’s
• Proven ability to manage multiple projects simultaneously
• Proven ability to perform against company identified performance targets
• Ability to self-direct, work well independently (with minimal supervision) and as a team
• Excellent oral and written communication/ presentation skills
• Skilled in Microsoft Office suite including PowerPoint and Excel
• Valid Driver’s License and Motor Vehicle Insurance

• Bachelor’s degree in healthcare, business administration or related field required.
• Masters preferred
• Clinical disciplines highly considered

• Two or more years’ experience in HMO, IPA or medical group, Physician Management Company, or other managed care organization.
• Consulting or Account Management experience preferred
• Clinical or practice operations experience highly considered
• Client relations experience valued. Provider relations experience preferred

Department: Network Relations
This is a full time position