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Sigma Systems

We are now Hansen Technologies. Follow us @Hansen-Technologies.

Provider Account Liaison/Provider Relationship Manager

Location

United States

Posted

4 days ago

Salary

0

Seniority

Senior

Bachelor Degree3 yrs expEnglish

Job Description

Provider Account Liaison/Provider Relationship Manager

Sigma Systems

• Assume a leading role in the education and implementation of the provider network and contracting strategies for all assigned providers. • Lead and manage relationship with assigned providers to proactively measure, anticipate and prevent problems as well as continually improve operational efficiencies and achieve corporate objectives around programs and strategic initiatives with providers. • Proactively identify provider issues; recommend solutions and ensure provider receives the necessary support and resources to carry out the solutions. • Coordinate in a matrixed liaison role with operations and support areas to ensure the appropriate development and execution of initiatives, communication needs, and issue resolution. • Act as a conduit back to project teams for provider input and feedback on strategic initiatives. • Work to gain consensus and incorporate necessary plan modifications. • Assist with contracting as it relates to implementing key provider strategies. • Engage appropriate resources, tools, analytics, and reports to enable success in the programs to drive better health outcomes, lower unit costs, and higher patient satisfaction for our members. • Oversee administration of critical and timely communication to providers through ongoing personal contacts, on-site field visits, regional communication sessions, and meetings with professional organizations to communicate initiatives and changes. • Develop, participate in, and support education to providers due to changing reimbursement environment, product portfolio, processing requirements, and new technology offerings. • Meet with contacts at various levels at key physician practices to ensure appropriate levels of communication and maintain harmonious relationships. • Maintain current market knowledge, industry knowledge and innovation awareness to drive the change needed to transform the way healthcare is delivered and reimbursed. • Collect market intelligence to contribute to strategic planning and design of products and networks. • Other duties as assigned or requested.

Job Requirements

  • Bachelor's Degree - Business, Healthcare related field OR prior experience in provider relations, healthcare or insurance industry
  • 3 - 5+ years of experience in the healthcare/insurance industry
  • In-depth understanding of the provider community (market knowledge) and global understanding of care delivery models and the insurance industry
  • Knowledge of reimbursement methodologies and models as well as financial and analytical modeling
  • Public speaking/delivering presentations
  • Negotiation skills
  • Process/quality improvement
  • Strong written and oral communication and organizational/project management skills
  • Broad knowledge and working experience with various software packages such as Microsoft PowerPoint, Excel, Word
  • Knowledge of required compliance with Centers of Medicaid and Medicare services (CMS) laws and regulations, policies and guidelines regarding Medicare Advantage and Medicaid plans; HIPAA privacy and security regulations

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