Provider Relationship Manager – Network Physician Engagement
Thanks for your interest in the Provider Relationship Manager – Network Physician Engagement position.
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Recruit, onboard, and launch new clinicians and medical groups into the network including marketing and outreach campaigns to promote services and clinical programs to the community and existing SWHR provider network to increase awareness, familiarity, and utilization of new providers. Identifies challenges to quality and cost-effective patient care across all service lines and specialties. Seeks out opportunities to engage new specialists, services and facilities. Utilizes market knowledge and multiple data sources to create strategic initiatives and action plans, which positively impact and improve care coordination. Create detailed presentations for leadership that identify opportunity and demonstrate solutions for improved integration and performance in value-based care.
Through active engagement and increased accountability, ensures and maintains the compliance of minimum work standards as defined by organizational leadership committees by partnering with various stakeholders and resources both internally and externally. Prepares detailed reports to establish value-based care performance data and potential barriers, outlining obstacles and establishing recommendations for improved partnerships. Consistently logs communications with providers, facilities, leadership teams, zone and entity leaders to maintain momentum and follow through for proven results. Create opportunities for primary care providers to engage with service line leaders, post-acute facilities, specialists and others to develop and maintain relationships (e.g., in services, remote sessions, etc.); share ideas with other regions to develop a set of best practices to increase connectedness. Actively monitor and ensure physician performance and compliance to network standards including but not limited to total cost of care, quality, network efficiency, risk adjustment, patient experience, and contract related carefully designed metrics. Work with clinicians to understand any challenges, reinforce expectations, facilitate solutions, and increase provider satisfaction to improve overall performance.
Maintains accurate records of action plans, physician credentialing, and ease of use opportunities, activities and correspondence with all stakeholders. Prepares ad hoc reports as requested by leadership, providers, practice executives, entity and zone leaders. Analyzes effectiveness of integration and impact on improved opportunities for care coordination. Monitor progress with Home Health, ED Admissions, and Pathology in terms of SWHR contracted and/or aligned vendors and facilities and communicate opportunities with SWHR primary care providers and specialists.
Qualifications
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High School Diploma or Equivalent 4 years additional experience in lieu of Bachelor's Degree (required) AND
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6 years’ Experience in Health Care, Managed Care, Consulting, Sales/Growth, Services, Insurance, or Account Management, without Bachelor's Degree (required) AND
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Valid Texas Driver’s License, Current Auto Insurance and Reliable Automobile Transportation Upon Hire (required)
OR
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Master's Degree Healthcare, Business, or related field (preferred)
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Bachelor's Degree Healthcare, Business, or related field (required) AND
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2 years’ Experience in Health Care, Managed Care, Consulting, Sales/Growth, Services, Insurance, or Account Management, with Bachelor’s Degree (required) AND
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Valid Texas Driver’s License, Current Auto Insurance and Reliable Automobile Transportation Upon Hire (required)
Position Responsibilities SWHR PCP Provider Relationship Manager performs:
Under the direction of the Manager of Network Performance, develop, implement and periodically enhance the provider performance strategy and network growth plan for assigned regions including but not limited to incorporating primary care physician feedback into the overall approach, identifying service line and location gaps, and market research. Actively engages stakeholders, including face to face outreach to THPG, UTSW, EPN, and other various private practice clinic employees, specialists and leaders. Collaborate with clinicians to establish and refine workflows that accomplish program and system goals of improving care coordination by reducing costs and increasing quality of care. Coordinate outreach efforts with appropriate parent organization liaison teams and facility/hospital administration.
Recruit, onboard, and launch new clinicians and medical groups into the network including marketing and outreach campaigns to promote services and clinical programs to the community and existing SWHR provider network to increase awareness, familiarity, and utilization of new providers. Identifies challenges to quality and cost-effective patient care across all service lines and specialties. Seeks out opportunities to engage new specialists, services and facilities. Utilizes market knowledge and multiple data sources to create strategic initiatives and action plans, which positively impact and improve care coordination. Create detailed presentations for leadership that identify opportunity and demonstrate solutions for improved integration and performance in value-based care.
Through active engagement and increased accountability, ensures and maintains the compliance of minimum work standards as defined by organizational leadership committees by partnering with various stakeholders and resources both internally and externally. Prepares detailed reports to establish value-based care performance data and potential barriers, outlining obstacles and establishing recommendations for improved partnerships. Consistently logs communications with providers, facilities, leadership teams, zone and entity leaders to maintain momentum and follow through for proven results. Create opportunities for primary care providers to engage with service line leaders, post-acute facilities, specialists and others to develop and maintain relationships (e.g., in services, remote sessions, etc.); share ideas with other regions to develop a set of best practices to increase connectedness. Actively monitor and ensure physician performance and compliance to network standards including but not limited to total cost of care, quality, network efficiency, risk adjustment, patient experience, and contract related carefully designed metrics. Work with clinicians to understand any challenges, reinforce expectations, facilitate solutions, and increase provider satisfaction to improve overall performance.
Maintains accurate records of action plans, physician credentialing, and ease of use opportunities, activities and correspondence with all stakeholders. Prepares ad hoc reports as requested by leadership, providers, practice executives, entity and zone leaders. Analyzes effectiveness of integration and impact on improved opportunities for care coordination. Monitor progress with Home Health, ED Admissions, and Pathology in terms of SWHR contracted and/or aligned vendors and facilities and communicate opportunities with SWHR primary care providers and specialists.
In addition to the required qualifications, a successful Provider Relationship Manager:
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Must be highly organized and detail oriented
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Excellent interpersonal and relationship building skills required
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Exposure to procedure interpretation and provider networking
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Ability to make quick, independent decisions
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Mutually beneficial negotiation skills
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Attention to detail
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Superior verbal and written communication skills
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Strong analytic, negotiations and issue resolutions abilities
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Proficient customer service and/ or sales experience
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Excellent working knowledge of MS office applications ( Word, Excel, Powerpoint, Access)
Why Southwestern Health Resources
As a Southwestern Health Resources you’ll enjoy: comprehensive benefits, including a 401(k) with match; paid time off; competitive health insurance choices; healthcare and dependent care spending account options; wellness programs to keep you and your family healthy; tuition reimbursement; a student loan repayment program; and more.
As a Southwestern Health Resources you’ll enjoy: comprehensive benefits, including a 401(k) with match; paid time off; competitive health insurance choices; healthcare and dependent care spending account options; wellness programs to keep you and your family healthy; tuition reimbursement; a student loan repayment program; and more.
Moving healthcare forward
At the heart of SWHR are people who help people. We care about those we serve and each other. To be the national leader in providing population-based healthcare, our more than 850 employees use their knowledge, data insights and clinical experience to deliver care to the right patient, at the right time and in the right setting. By connecting physicians to patients and clinical insights to better outcomes, SWHR lowers costs, optimizes value, and builds a better healthcare system for all.
At the heart of SWHR are people who help people. We care about those we serve and each other. To be the national leader in providing population-based healthcare, our more than 850 employees use their knowledge, data insights and clinical experience to deliver care to the right patient, at the right time and in the right setting. By connecting physicians to patients and clinical insights to better outcomes, SWHR lowers costs, optimizes value, and builds a better healthcare system for all.
We invite you to learn more about us at www.southwesternhealth.org.
Let’s move healthcare forward – together.
Highlights:
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Combining the strengths of UT Southwestern Medical Center, Texas Health Resources and more than 2,500 community physicians, we offer the largest provider network in North Texas. SWHR covers approximately 700,000 patient members across 16 counties in North Texas.
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SWHR is the parent organization of Care N’ Care Insurance Co., a leading regional Medicare Advantage health plan organization that serves approximately 17,000 patients in North Texas.
Additional perks of being a SWHR Provider Relationship Manager
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Gain a sense of accomplishment by contributing in a teamwork environment
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Positively impact patients’ quality of life
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Receive excellent mentorship, comprehensive training and dedicated clinical leadership resources
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Enjoy opportunities for growth
Explore Southwestern Health Resources Careers for more information and to search all career opportunities.
Our Recruitment team invites you to contact us with any questions at recruitment@texashealth.org.