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Representative, Client Network Management / Southern CA (Orange County)
As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!
Accountable for a wide range of duties in support of complete and accurate client provider networks, including but not limited to, provider office trainings and visits, provider recruitment and membership maintenance and growth.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
- Accountable to visit on a regular and constant basis all client primary and specialty provider offices for all clients as assigned, including but not limited to, quality performance domains.
- Responsible to inform provider and office manager of client notices, payor updates, and regulatory requirements, including but not limited to, review of gaps in care, encounter submission volumes, access and availability requirements.
- Accountable to grow the provider network and client membership through new provider recruitment and business development opportunities. Responsible to gather and prepare presentation materials for the office visits.
- Responsible to organize and conduct office managers in-service, including but not limited to, providing the quality training and education materials.
- Accountable to maintain visit and activity logs of provider visits and identify and track issues raised by provider or office manager during the visit. Responsible to escalate issues to practice manager/director for tracking and issue resolution.
This position reports to the Manager, Provider Quality Performance and requires moderate degree of supervision to ensure provider visits and office manager forums occur as required and scheduled.
KNOWLEDGE, SKILLS, ABILITIES
Candidates that exhibit most of the following preferred qualifications will be well suited for this position. However,
- 2-4 years of health plan or management service organization experience in provider relations or related area
- 2+ years in managed care experience preferred
EDUCATION / EXPERIENCE
- High School Diploma or GED
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to work in a sitting position, use a computer and answer telephone
- Light physical effort (lift to 10 lbs.).
- The home office for this position will be located in Encino, CA.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Office Work Environment
- Hospital Work Environment
- This position requires local travel (within 50-mile radius) at least 80% of the time.
Employment practices will not be influenced or affected by an applicant’s or
employee’s race, color, religion, sex (including pregnancy), national origin,
age, disability, genetic information, sexual orientation, gender identity or
expression, veteran status or any other legally protected status. Tenet will
make reasonable accommodations for qualified individuals with disabilities
unless doing so would result in an undue hardship.
Tenet participates in the E-Verify program. Follow the link below for additional information.
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