Sr Provider Relations Liaison - Comm. Network Operations - Pearland Admin Office - Kelsey Seybold Clinic

About the role

Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs.

Responsibilities

The Senior Provider Relations Liaison is responsible for establishing and maintaining solid positive business relationships with current and potential Kelsey-Seybold and KelseyCare Advantage affiliate and employed providers to ensure stable and geographically disperse networks for the Kelsey-Seybold commercial and Medicare Advantage health plans and KS Plan Administrators' health plan products.

• Providing educational instruction and support to physicians and their staff
• Being the main point of contact for the respective providers and will routinely visit physician's offices for issues concerning the achievement of quality outcomes, provider satisfaction, medical cost targets, network growth and/or efficiency targets
• Responsibility for education of the physicians and office staff on health plan products and benefits, policy and procedure for multiple managed care plans, assistance with claims payments and other duties as assigned
• Travel requirements - local and extensive

Requirements

• 5+ years of professional level experience in clinic or healthcare operations
• CPT and ICD-10 coding and prior experience with reimbursement methodologies
• Proven knowledge of claims processing, clinic operations, managed care plan benefits and utilization management policies and procedures
• Network development and/or provider relations experience
• Microsoft Word and Excel experience
• Proven analytical and problem-solving skills; ability to communicate effectively in writing and verbally
• Proven public speaking and presentation skills
• Valid Texas Driver's License and ability to travel
• Own or lease a working vehicle and be able to travel daily within the Greater Houston area

Preferred Qualifications

• 5+ years of experience in applicable healthcare administrative operations
• 3+ years of experience in Medicare/Commercial products
• Ability to interpret provider contracts and regulatory contracts
• Experience with the development of provider relations and/or clinical networks
• Ability to work in a fast-paced environment; demonstrated ability to perform multiple concurrent tasks with minimal supervision and meet deadlines
• Proficiency with Excel and/or PowerPoint
• Excellent communication and relationship development skills with multiple different types of stakeholders
• Outcomes driven
• Capable of managing a variety of complex issues while driving momentum of key projects

Pay

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment.

Benefits

In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).