Network Engagement Representative - Intermountain Health
Montpelier, VT
About the Job
Job Description:
Strategically develop and manage highly aligned member focused health insurance networks by partnering with hospital and clinic administrations, Intermountain Medical Group and affiliated practitioners demonstrating sound business decisions. May work with regional hospital leaders; and developing relationships of trust.
Job Essentials
1. Establishes and maintains strategic business relationships with providers with a focus on member needs, specifically access and affordability. Acts as a strategic partner with provider offices and the organization to help build and manage aligned relationships.
2. Provides strategic input and network recommendations for Community Based Care, Specialty Based Care, Multi-specialty clinics, Intermountain Medical Group, or Behavioral Health providers to Directors and Executive level leadership.
3. Researches and prepares information regarding providers requesting to join SelectHealth Networks to present at the Participating Practitioner Steering Committee (PPSC). Participates in PPSC committee to determine provider status on networks.
4. Provides education to physician offices regarding such things as industry and market trends, SelectHealth strategic direction and value-based health care and other products. Review reports, Dashboards, Provider Insights and other information relevant to their practices. Gains understanding of fee schedule methodology, Participating Practitioner Service Agreements (PPSA), Medical Staff Services and other credentialing processes to effectively educate providers and staff.
5. Carefully documents provider interactions, issues, concerns and other pertinent information in appropriate department systems for review, historical perspective and continuity.
6. Leads and organizes provider education events.
7. Consistently works with all levels of management to sustain an integrated and aligned relationship with administrators and providers in assigned specialties.
8. May be asked to participate in special projects related to market trends and strategic direction.
9. Uses sound judgment to facilitate and recommend changes to internal policies and procedures to managers where necessary. May facilitate resolution of management level issues, questions and problems.
10. Anticipates and recognizes issues and is proactive in problem resolution. May oversee the problem-solving process.
11. Works closely with departmental operations, contracting and compliance teams to effectively develop and manage internal relationships and contracting processes. Works with other organizational departments and teams to coordinate strategic programs, initiatives and other member centric programs.
Minimum Qualifications
Bachelor's degree in Health Care Administration or business related field. Education must be obtained through an accredited institution. Degree will be verified.
- or -
Four years of health care experience in health care.
- and -
Two years of experience working with health care providers at a professional sales or service position.
- and -
Basic working knowledge of word processing and spreadsheet progrmas.
- and -
Demonstrated ability to work independently and execute organizational goals with minimal oversight.
Preferred Qualifications
Excellent presentation and communication skills.
- and -
Demonstrated effective interpersonal and problem-solving skills.
- and -
Experience taking proactive initiative.
- and -
Demonstrated ability to make business and strategic suggestions.
- and -
Health insurance claims payment system experience or other frontline health insurance experience.
Physical Requirements:
SH only
Interact with others requiring the employee to communicate information.
- and -
Operate computers and other office equipment requiring the ability to move fingers and hands.
- and -
See and read computer monitors and documents.
- and -
Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.
Location:
SelectHealth - Murray
Work City:
Murray
Work State:
Utah
Scheduled Weekly Hours:
40
The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$26.84 - $42.28
We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers (https://intermountainhealthcare.org/careers/working-for-intermountain/employee-benefits/) , and for our Colorado, Montana, and Kansas based caregivers (http://www.sclhealthbenefits.org) ; and our commitment to diversity, equity, and inclusion (https://intermountainhealthcare.org/careers/working-for-intermountain/diversity/) .
Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
All positions subject to close without notice.
Strategically develop and manage highly aligned member focused health insurance networks by partnering with hospital and clinic administrations, Intermountain Medical Group and affiliated practitioners demonstrating sound business decisions. May work with regional hospital leaders; and developing relationships of trust.
Job Essentials
1. Establishes and maintains strategic business relationships with providers with a focus on member needs, specifically access and affordability. Acts as a strategic partner with provider offices and the organization to help build and manage aligned relationships.
2. Provides strategic input and network recommendations for Community Based Care, Specialty Based Care, Multi-specialty clinics, Intermountain Medical Group, or Behavioral Health providers to Directors and Executive level leadership.
3. Researches and prepares information regarding providers requesting to join SelectHealth Networks to present at the Participating Practitioner Steering Committee (PPSC). Participates in PPSC committee to determine provider status on networks.
4. Provides education to physician offices regarding such things as industry and market trends, SelectHealth strategic direction and value-based health care and other products. Review reports, Dashboards, Provider Insights and other information relevant to their practices. Gains understanding of fee schedule methodology, Participating Practitioner Service Agreements (PPSA), Medical Staff Services and other credentialing processes to effectively educate providers and staff.
5. Carefully documents provider interactions, issues, concerns and other pertinent information in appropriate department systems for review, historical perspective and continuity.
6. Leads and organizes provider education events.
7. Consistently works with all levels of management to sustain an integrated and aligned relationship with administrators and providers in assigned specialties.
8. May be asked to participate in special projects related to market trends and strategic direction.
9. Uses sound judgment to facilitate and recommend changes to internal policies and procedures to managers where necessary. May facilitate resolution of management level issues, questions and problems.
10. Anticipates and recognizes issues and is proactive in problem resolution. May oversee the problem-solving process.
11. Works closely with departmental operations, contracting and compliance teams to effectively develop and manage internal relationships and contracting processes. Works with other organizational departments and teams to coordinate strategic programs, initiatives and other member centric programs.
Minimum Qualifications
Bachelor's degree in Health Care Administration or business related field. Education must be obtained through an accredited institution. Degree will be verified.
- or -
Four years of health care experience in health care.
- and -
Two years of experience working with health care providers at a professional sales or service position.
- and -
Basic working knowledge of word processing and spreadsheet progrmas.
- and -
Demonstrated ability to work independently and execute organizational goals with minimal oversight.
Preferred Qualifications
Excellent presentation and communication skills.
- and -
Demonstrated effective interpersonal and problem-solving skills.
- and -
Experience taking proactive initiative.
- and -
Demonstrated ability to make business and strategic suggestions.
- and -
Health insurance claims payment system experience or other frontline health insurance experience.
Physical Requirements:
SH only
Interact with others requiring the employee to communicate information.
- and -
Operate computers and other office equipment requiring the ability to move fingers and hands.
- and -
See and read computer monitors and documents.
- and -
Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.
Location:
SelectHealth - Murray
Work City:
Murray
Work State:
Utah
Scheduled Weekly Hours:
40
The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$26.84 - $42.28
We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers (https://intermountainhealthcare.org/careers/working-for-intermountain/employee-benefits/) , and for our Colorado, Montana, and Kansas based caregivers (http://www.sclhealthbenefits.org) ; and our commitment to diversity, equity, and inclusion (https://intermountainhealthcare.org/careers/working-for-intermountain/diversity/) .
Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
All positions subject to close without notice.
Source : Intermountain Health