Provider Relationship Manager - Network Physician Engagement - Southwestern Health Resources (SWHR)

Here’s What You Need

Education

• High School Diploma or equivalent with an additional 4 years of experience in lieu of Bachelor's Degree required.
• Bachelor’s Degree in Healthcare, Business or related field required.
• Master’s Degree in Healthcare, Business, or related field highly preferred.

Experience

• Requires 2 years’ experience in Health Care, Managed Care, Consulting, Sales/Growth, Services, Insurance, or Account Management, with Bachelor’s Degree, OR,
•  Requires 6 years’ experience in Health Care, Managed Care, Consulting, Sales/Growth, Services, Insurance, or Account Management, without Bachelor’s Degree.

Licenses & Certifications

• Valid Texas Driver’s License, current Auto Insurance and reliable automobile transportation upon hire required.

Skills & Abilities

• Excellent interpersonal and relationship building skills required.
• Exposure to procedure interpretation and provider networking.
• Ability to make quick, independent decisions.
• Mutually beneficial negotiation skills.
• Attention to detail.
• Superior verbal and written communication skills.
• Strong analytic, negotiations and issue resolutions abilities.
• Proficient customer service and/ or sales experience.
• Excellent working knowledge of MS office applications (Word, Excel, PowerPoint, Access).

What You Will Do

Position Responsibilities

The Provider Relationship Manager will be responsible for network performance and management with SWHR PCPs for an assigned geographic area. This role will develop collaborative relationships and rapport with assigned SWHR PCPs and network providers and monitor performance against carefully designed metrics and standards.

Position Functions

• 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.

Why Southwestern Health Resources 

As a Southwestern Health Resources employee, 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.

• Additional perks of being an SWHR employee:
• Gain a sense of accomplishment by contributing to a teamwork environment.
• Positively impact patients’ quality of life.
• Receive excellent mentorship, comprehensive training and dedicated clinical and administrative leadership resources.
• 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