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Representative, Client Network Management (remote)/ Northern CA (Santa Clara County)

Job ID: 2105020893 Date posted: 08/12/2021 Facility: Conifer Health Solutions
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Job Details

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!

JOB SUMMARY

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.

SUPERVISORY RESPONSIBILITIES

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.



Qualifications:

Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.

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

REQUIRED CERTIFICATIONS/LICENSURE

  • No

PHYSICAL DEMANDS

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.

WORK ENVIRONMENT

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

TRAVEL

  • This position requires local travel (within 50-mile radius) at least 80% of the time.
Job: Conifer Health Solutions
Primary Location: California
Job Type: Full-time
Shift Type: Days

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.

E-Verify: http://www.uscis.gov/e-verify

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