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Chairing the Partner Provider and Safety Committee meetings; working closely with the Center’s Board of Directors and CFO; and onboarding new tenant providers after sufficient vetting of their fit with the Center’s mission and vision.
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The Senior Provider Contract Administrator (SPCA) will be responsible for supporting provider contracting for designated accounts as assigned by the Vice President, PNM and under the direction of a Director, PNM using a coordinated team approach, which typical includes the Director, the SPCA and one or more Provider Services Administrators.
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Three years of provider relations, provider claims/reimbursement, or contracting experience. Facilitates provider trainings, orientations, and coaches for performance improvement within the network and assists with claim resolution.
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Then you'll love being an Edge Kid's Coach!
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Through its provider contracting function, HAP is looking to secure Alternative Payment Model (APM) agreements with POs, PHOs, IPAs and clinically integrated network (collectively APM Entities or APMEs) which reward providers for managing the total cost of care (TCOC), quality (e.g. MA Stars), accurate data collection that results in appropriate risk score recognition, general performance improvement initiatives (e.g. leakage avoidance) and member growth.
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This includes, but is not limited to, liaising with providers and office staff, retrieving medical records, scanning, and uploading pertinent clinical documentation, responding to risk-adjustment inquires, and overseeing general provider education and engagement efforts.
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Initiates, negotiates, generates and tracks provider Letters of Agreement, contracts and amendments from initial draft to full execution utilizing approved standardized contract templates/amendments, including but not limited to Fee for Service and Basic Alternative Payment Methods including Pay for Performance.
Starting at $59,810.6 - $129,589.63 a year depends on education, experienceFull-timeExpandApply NowActive JobUpdated 2 months ago - UpvoteDownvoteShare Job
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We currently have an exciting Per Diem career opportunity available to join the HKNC team as a Service Support Provider/Driver. Note: this position requires travel through Oakland County Michigan, etc.
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Knowledgeable of the medical marketplace, and with two to four years of experience, preferably in a managed care situation, (If you have a working knowledge of the physical therapy industry, even better) Provider Relations Coordinators are masters when it comes to telephone communication.
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Be a part of our team that takes great pride in helping others succeed!
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