Location: Work from home (Pennsylvania) Shift: Days (United States of America) Scheduled Weekly Hours: 40 Worker Type: Regular Exemption Status: Yes Job Summary: Represents the Health Plan and Provider relationship at the highest level. The position will work on complex issues where analysis and strategy require significant evaluation and collaboration. Responsible for establishing and maintaining Strategic Partnerships with Providers, communicating the vision and goals of the health plan, and supporting the development of the highest possible provider partnerships. In addition, the incumbent is expected to provide professional and exceptional service to our provider network. Job Duties: Serves as a primary relationship manager with providers to ensure a positive provider experience and promote network retention. Supports new assigned providers with onboarding, including orientation session(s). Responds to assigned provider questions or inquires, and if necessary, ensures prompt resolution to provider issues with appropriate teams to drive results. Monitors data, presents reports, and encourages ongoing provider engagement through regularly scheduled touch bases and meetings. Reports regularly on referral volume by channel, tracking activity and effectiveness of outreach. Works with Providers across all areas including financial performance and value based programs. Resolves the most complex provider issues and collaborates with internal teams to drive to resolution. Influences strategy not just for their providers, but also for the department. Partners with quality improvement department for delivery of quality results and value based program results. Prepares in depth analysis and make decisions on complex issues. Creates strategic plans for providers in order to support the goals of the health plan. Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. *Relevant experience may be a combination of related work experience and degree obtained (Associate’s Degree = 2 years; Bachelor’s Degree = 4 years). Position Details: Education: High School Diploma or Equivalent (GED)- (Required), Bachelor's Degree- (Preferred) Experience: Minimum of 7 years-Relevant experience* (Required) Certification(s) and License(s): Skills: Builds Relationships, Communication, Computer Literacy, Critical Thinking, Group Presentations, Health Insurance OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION : We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family. We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.
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