Sr Provider Engagement Rep - Community Health Choice
Harris Health System
Location: Houston, Texas
Type: Full Time
Internal Number: 159069
The Senior Provider Engagement Representative is field-based and is responsible for building and maintaining partnerships with Physicians, Hospitals, Ancillaries, and large or complex Physician organizations (Providers). Ensures consistent communication, support, and education to Providers on relevant topics, including but not limited to identified claims and/or authorization issues, new initiatives, availability and functionality of Community's Provider Portal. Primary lead for Joint Operating Meetings of assigned Providers. Serves as a subject matter expert in Community's incentive program(s); requests, analyzes and reviews provider-specific reports; offers alternatives and/or resolutions to undesirable report findings. Identifies and disseminates best practices within the Network and adheres to the Provider Communication and Interaction Guidelines. Collaborates with leadership, co-workers, and staff in other departments to achieve departmental and organizational objectives.
High School or equivalent required. BA/BS in Business preferred
5 years' experience in managed care (Provider Relations/Services; Claims Adjudication, Medical Coding, Contracting)
Microsoft Office (Word, Excel, PowerPoint); QNXT and CACTUS system preferred
Communication Skills: Above Average Verbal (Heavy Public Contact) Writing /Composing: Correspondence/Reports
Other Skills: Analytical, Medical Terminology; MS Word, MS Excel, MS PowerPoint
Work Schedule: Flexible
Other Requirements: Must have valid driver's license and car insurance. Exhibit excellent communication and interpersonal skills by demonstrating solid verbal and written communication skills with internal and external customers ensuring that both oral and written communications are both constructive and professional at all times.
The Harris Health System is a fully integrated healthcare system that cares for all residents of Harris County, Texas. We are the first accredited healthcare institution in Harris County to be designated by the National Committee for Quality Assurance as a Patient-Centered Medical Home, and are one of the largest systems in the country to achieve the quality standard. Our system includes 23 community health centers, five school-based clinics, a dental center and dialysis center, mobile health units, a rehabilitation and specialty hospital and two full-service hospitals.Ben Taub Hospital is a world renowned Level I Trauma Center with 586 licensed acute-care beds and provides a wide range of specialty care outpatient services. Lyndon B. Johnson Hospital is a 328 licensed bed acute-care hospital with a newly expanded Level III trauma center and a distinguished regional center for neonatal intensive care for high-risk deliveries.Harris Health is a teaching system for Baylor College of Medicine and The University of Texas Health Science Center at Houston (UTHealth). We train the next generation of healthcare providers on the latest medical procedures and technological breakthroughs.With... our fully integrated electronic medical records system, we offer patients the convenience and assurance that their medical history is accurate, safe and available when and where it is needed. Our Medical Home designation ensures that we offer a full range of preventive, specialty and acute care services for the entire family.