Senior Provider Relations Professional Bilingual - English/Mandarin/Cantonese/Korean - LA County CA

Profile

Description

The Senior Provider Relations Professional develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan. The Senior Provider Engagement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Primary focus will be strategizing the growth and experience of multicultural providers. Requires working closely with physicians, physician office staff and brokers to develop and operationalize multicultural growth and retention strategies.

Responsibilities

The Senior Provider Relations Professional represents the scope of health plan/provider relationship across such areas as financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, operational improvements and other areas as they relate to provider performance, member experience, market growth, provider experience and operational excellence. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

Required Qualifications


3 - 5 years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience
Bilingual in English and one of the following: Cantonese, Mandarin, or Korean
Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies
Demonstrated ability to manage multiple projects and meet deadlines
Strong communication and presentation skills with ability to effectively communicate with all levels of the organization, internally and externally
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Must live in Southern California with the ability to travel within the region up to 50% of the time


Preferred Qualifications


Bachelor's Degree
Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance
Comprehensive knowledge of Medicare policies, processes and procedures


Additional Information

This is a remote position to be located in Southern California, preferably in Los Angeles County. As the environment changes and we return to normal business operations, this person will be required to travel to provider offices within the region up to 50% of the time.

Scheduled Weekly Hours

40

Company info

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