PCP Provider Engagement Representative – Farmers Branch, TX SWHR CIN

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21000839 Requisition #
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Southwestern Health Resources (SWHR CIN) seeks to hire a PCP Provider Engagement Representative to work Full Time supporting the Provider Engagement department.
 
Please note: Southwestern Health Resources Clinically Integrated Network (SWHR CIN) is an affiliated company of Texas Health and UT Southwestern.  If hired for this position, you will become a SWHR CIN employee rather than a Texas Health or UT Southwestern employee.
 
The address is 8150 Brookriver Drive, Dallas, Texas 75247.
 
After SWHR Covid protocol ends, this position will office at the SWHR Corporate Headquarters, 1603 LBJ Freeway, Farmers Branch, Texas 75234
 
Salary range is Min $28.04 - Max $42.78 – based on relevant experience
 
 
 
Job Description
 
The Primary Care Provider Engagement Representative is responsible for serving as account manager for various primary care practices within the Southwestern Health Resources (SWHR) Clinically Integrated Network (CIN). This position will directly interact with primary care physicians, advanced practice providers (APPs), practice administrators and various office staff to deliver a differentiated provider experience and drive performance against SWHR organizational goals.
 
The position will serve as frontline for deploying SWHR population health strategies, resources and tools to the primary care provider network and will be the point person for primary care practices across various SWHR departments. 
 
RELATIONSHIP BUILDING:
Lead recurring provider engagement through various channels including pod meetings, special education sessions, and other group or individual interactions.
Establish and maintain relationships with assigned physicians through office visits, telephone calls, prompt resolution of issues, and overall excellent customer service.
Share practice performance results with PCP and Office Manager on a regular basis and make recommendations for actions that will drive positive results.
Maintain high service levels with primary care provider practices and be responsible for keeping "finger on the pulse" of the primary care provider network related to opportunities for improvement with SWHR.
Acts as primary contact for provider practices to resolve issues between provider and Managed Care Organizations (MCOs).
Own issues raised by provider practices related to SWHR throughout the issue lifecycle-from identification, monitoring through resolution, by coordinating with appropriate SWHR stakeholders.
Identify and execute on opportunities for enhancing provider experience, performance or for streamlining internal operations to increase productivity and effectiveness.
Own provider data in Customer Relationship Management Platform (CRM) for assigned practices and ensure integrity and completeness of all provider data including demographic information, NPIs, TINs, managed care information, enrollment dates, SWHR internal assignments, technology platform information, and others as directed by supervisor.
Build internal processes to foster close working relationship with other SWHR departments and partners to drive success.
Participate in provider events organized by SWHR as requested and perform required duties.
Conduct surveys and various ad-hoc campaigns across SWHR primary care provider network as necessary.

OPERATIONS:
Develop and implement processes within the SWHR primary care practices that directly drive results related to SWHR initiatives for both revenue and expense.
Track and communicate provider performance through distribution of reports and dashboards; identify underperforming physician and escalate through appropriate channels; work closely with assigned SWHR Medical Directors to deliver appropriate messaging to providers.
Thoroughly understand various SWHR and payer performance incentive programs and communicate regularly to providers the methodology, their current and anticipated results, and answer questions/concerns as appropriate.
Adhere to department policies and procedural manuals as well as be responsible for leaning and enforcing new guidelines as they are developed.
Meet established performance/productivity standards set by supervisor; maintain clear communication with supervisor to ensure transparency and minimal operational disruptions. 

ONBOARDING:
On-board community physicians onto contracts, processes, technology platforms, resources and tools after they are recruited into SWHR.
Conduct educational workshops and orientations as necessary for participating providers and staff on a regular basis to enhance their understanding of contracted managed care products, SWHR or payer policies and procedure, SWHR technology platforms, performance incentive programs, clinical guidelines and best practices. 

COMPLIANCE:
Ensure assigned community providers are current on SWHR membership dues and coordinate with SWHR Finance to notify provider on dues and follow up as necessary to drive collections.
Gather, review, and verify all pertinent information related to MCOs; ensure that any updated, changes, etc. that would impact network physicians and staff are disseminated to appropriate personnel in a timely manner.
Track and report on activities as required by management in a time and organized manner. 
Q
The ideal candidate will possess the following qualifications:
 
Education
Bachelor's Degree Healthcare, Business, Science, Marketing, Communication Required
2 years’ Experience in Health Care, Managed Care, or Practice Management (with Bachelor's Degree) Required
 
Or
 
Master's Degree Healthcare, Business, Science, Marketing, Communication Preferred
2 years’ Experience in Health Care, Managed Care, or Practice Management (with Master's Degree) Required
 
Or
 
High School Diploma and Equivalent 4 years' Additional Experience in lieu of Bachelor's Degree Required
6 years’ Experience in Health Care, Managed Care, or Practice Management (without Bachelor's Degree) Required
 
Travel Requirements
Local 75% travel to Provider Practices or other relevant locations in the DFW area as necessary

Licenses and Certifications
Valid Texas Driver’s License, current Auto Insurance, and reliable Automobile Transportation Upon Hire Required

Skills
Must be highly organized and detail oriented
Must have discretion, good judgment, personal motivation and the ability to work independently
Excellent oral, written and interpersonal communication skills
Excellent problem solving and troubleshooting skills with the ability to exercise mature judgment
Proficiency working with Microsoft Word, Excel and PowerPoint; experience in Salesforce is a plus
Must be able to problem solve, make decisions, interpret data, organize and analyze workflows, write, plan, use math formulas, and simple arithmetic.
Ability to run reports, perform analysis and summarize results
Ability to interpret and present complex analytical information and effectively communicate results
Ability to create customized action plans to drive results
Ability to manage multiple task assignments
Ability to establish priorities, solve problems and deal with a variety of variables in situations where only limited standardization exists
Ability to identify trends and escalate issues where the root cause is not isolated to one error
Flexible schedule and availability to attend business meetings during early mornings and evenings outside of normal 8 am to 5 pm business hours
Ability to exhibit confidence when working directly with physicians and their staff
Demonstrate a general knowledge of healthcare delivery systems; knowledge of risk adjustment, quality, utilization and care management is a plus
Comfortable with working in a dynamic environment and meeting high performance expectations
Must be able to uphold confidentiality requirements of the organization
Must be dependable, self-motivated, and exhibit initiative
Must be able to operate general office equipment including but not limited to computer, phones, and related media and information devices
 
Supervision
Individual Contributor

ADA Requirements
Extreme Heat 1-33%
Extreme Cold 1-33%
Extreme Swings in Temperature 1-33%
Extreme Noise 1-33%
Working Outdoors 67% or more
Working Indoors 1-33%
Mechanical Hazards 1-33%
Electrical Hazards 1-33%
Explosive Hazards 1-33%
Fume/Odor Hazards 1-33%
Dust/Mites Hazards 1-33%
Chemical Hazards 1-33%
Toxic Waste Hazards 1-33%
Radiation Hazards 1-33%
Wet Hazards 1-33%
Heights 1-33%
Other Conditions 1-33%


Physical Demands
Sedentary
 

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