Network Engagement Representative Senior - SCL Health

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; and developing relationships of
trust. Coach junior representatives and inform leadership on strategic issues.
A large part of this role will be, PPSA which will entail contracting with
provider groups to bring them over to Select Health's provider network.
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 to present at the Participating
Practitioner Steering Committee (PPSC) regarding providers requesting to
join SelectHealth Networks 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. Uses in-depth 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, organizes and may present topics in 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 lead or facilitate special projects related to market
trends and strategic direction.
9. Uses sound judgment to facilitate and recommend changes to internal
policies and procedures where necessary. May facilitate resolution of
executive 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.
12. Provides informal coaching, training and mentoring to teammates as
necessary.
13. PPSA contracting working with providers groups to bring them over to the
Select Health provider network.
#SelectHealth
Minimum Qualifications
Bachelor's degree in Health Care Administration or business related field or
four years of health care experience. Degree must be obtained through an
accredited institution. Education is verified.
Four years of experience working with health care providers at a professional
sales or service position.
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Intermediate working knowledge of word processing and spreadsheet programs.
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Demonstrated history or working independently and executing organizational
goals with minimal oversight.
Preferred Qualifications
Management level experience.
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Ability to think and communicate strategically on various health care related
topics.
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Demonstrated ability to build effective strategic business relationships.
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Demonstrated ability to make sound business decisions and str tegic
suggestions.
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Demonstrated proactive initiative.
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Excellent communication and presentation skills.
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Demonstrated effective interpersonal and problem resolution skills.
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Clinical or health insurance experience.
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Demonstrated ability to work well in a team setting. i.e. assisting team in
reaching team goals, taking on additional workloads when necessary to
support the team and constructively coaching in a positive manner.
Physical Requirements:SH only
Interact with others requiring the employee to communicate information.
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Operate computers and other office equipment requiring the ability to move
fingers and hands.
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See and read... For full info follow application link.