Provider Outreach Specialist at AdventHealth

Date Posted: 10/23/2020

Job Snapshot

  • Job Schedule
    Full-Time
  • Location:
    Tampa, FL
  • Date Posted:
    10/23/2020
  • Job ID:
    20018144
  • Job Family
    Population Health
  • Travel
    Yes, 100 % of the Time
  • Shift
    1 - Day

Job Description


Description

Provider Outreach Specialist | AdventHealth Corporate

Location Address: 3903 Northdale Blvd, Tampa, Florida 33624

Top Reasons to Work at AdventHealth Corporate

  • Great benefits
  • Immediate Health Insurance Coverage
  • Career growth and advancement potential
Work Hours/Shift:
  • Full-Time, Monday – Friday

You Will Be Responsible For:

  • Hosts regular meetings with network physicians, office staff, and necessary clinical staff to review contract performance and collaborates on improvement strategies and schedule follow-ups.
  • Reviews transparent quality and utilization reports along with specific patient and payor data with network physicians and office staff and connects practice to relevant support for performance improvement. 
  • Support low performing physicians through performance improvement process in collaboration with AHPN Medical Director and assist leadership and AHPN governance structure to evaluate high, medium, and low performers in the network.
  • Uses knowledge to help connect key concepts and expectations, ultimately presenting the Regional Market CIN, and/or affiliated payer networks/health plans, in a manner that is simple for providers to relate to. Regular rounding to communicate messages about the value of solutions, strategies, performance/incentive models, policies, procedures and timely issue resolution.
  • Onboarding providers for Provider Networks and affiliated payer networks/health plans to ensure provider is informed and engaged related to essential information.
  • Facilitates practice change management in regards to emerging trends related to population health initiatives, reimbursement models, patient satisfaction, customer outreach, panel growth, and provider performance with quality and efficiency metrics. The Specialist should be seen as an asset to their practices by providing transparent data and recommending enhancements to help ensure success in the value-based healthcare environment.
  • Actively participates in continuing education topics and suggests topics or items based on conversations occurring in the field or based on other perceived gaps in education.
  • Responsible for tracking, measuring, analyzing, and reporting on provider contacts, updating provider demographics, validating provider contact information, and reporting issues in the designated provider reporting tool.
  • Fully understands the provider and ancillary makeup of the provider network, and affiliated payer networks in order to provide relevant feedback and intel related to potential needs.
  • Responsible for maintaining and understanding assigned territories including market attributes, providers in the community, and other pertinent information.
  • Works seamlessly, effectively, and in harmony with all internal teams including, but not limited to, MSO, Regional Market CIN, and/or affiliated payer networks/health plans credentialing, provider resolution center, quality and care integration, provider engagement education, and analytics to ensure integrated operations that result in a superior consumer experience for the provider.
  • Responsible for maintaining operational knowledge of Cerner HealtheIntent or any similar business intelligence tools and assisting providers with understanding and utilization of such tools and engaging other MSO, Regional Market CIN, and/or affiliated payer networks/health plans resources/teams as needed.

Qualifications
What You Will Need:

Education and Experience Required:

  • Bachelor’s Degree in healthcare, business or a related field; or 6+ years of related experience.
  • 3+ years’ experience in performance improvement, operations, marketing or in a relevant physician/ hospital/ managed care environment.
  • 3+ years’ experience working collegially with physicians

Knowledge and Skills Required:

  • Demonstrated excellent relationship management skills
  • Demonstrated excellent negotiation skills
  • Knowledge of health plan/claims-related processes (Clinical Procedural (CPT) coding knowledge a plus)
  • Knowledge of hospital and provider (multi-specialty group, IPA or PHO) operations and services impacted by managed care and health care reform
  • Knowledge about both the clinical and financial aspects of managed care, including capitation and global budgets
  • Demonstrated basic knowledge of processes within the ambulatory practice/provider setting
  • Demonstrated experience in preparing and delivering written and oral reports
  • Strong skills for using various information systems tools to identify performance improvement opportunities, communicate these opportunities to providers and track improvements
  • An understanding of health plan operations and network quality and efficiency initiatives related to providers, including reporting and attestation of quality measures
Job Summary:

The purpose of this position is to provide population health subject matter expertise, consultation and education to network providers (market/region dependent) by establishing and maintaining a strong relationship with the provider and practice. The Provider Outreach Specialist is expected to make regular visits to provider practice offices, with the intent to advise and educate on a wide variety of topics. Examples include population health management strategies and programs, clinical integration, incentive program(s), provider web portals, quality care gap closure efforts, and provider network policies and procedures.

The Provider Outreach Specialist is designed to provide value to the network provider and practice through expertise, consultation, change management, and provider engagement.  The Provider Outreach Specialist is the relationship manager for the practice and exists to help simplify the provider’s experience with the Regional Market CIN, and/or affiliated payer networks/health plans while working to identify and address improvement opportunities.  As part of the Regional Market Outreach Team, the Provider Outreach Specialist will be responsible for executing plans as it relates to value-based performance including quality, cost and patient experience opportunities, and delivering key messages to providers and office staff.  This position is field-based with the majority of time spent in provider offices.



This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

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