Provider Relations Specialist - Fort Myers, United States - Lee Health
Description
Location:Lee Health Corporate Center -4211 Metro ParkwayFort Myers FL 33916
Department: Business Development and Contracting
Work Type: Full Time, Salaried/Exempt
Shift: Shift 1/ to
Minimum to Midpoint Pay Rate:$57, $74,547.20
Summary
This position is responsible for the development and management of tools to ensure timely and accurate access to information that is needed to support LMHS and PHO managed care payor contracts and to support access to appropriate information via the LMHS and PHO website. Such information includes physician participation in managed care payor contracts for LMHS employed physicians and PHO participating physicians, master list of all managed care payor agreements for all LMHS entities, tracking mechanism for contract renewal dates and tracking for expired contracts. Must ensure all relevant information can be formatted into a variety of report structures for different needs of the organization. Also maintains comprehensive fee schedule data to allow for assessment of physician payment structures and participates in analyzing such structures. Also responsible for performing provider relations activities, dissemination of contractual information to essential parties, monitoring contract compliance, and developing and maintaining relationships with key managed care entities in the market. This position has a hybrid schedule.
RequirementsEducational Requirements
Degree/Diploma ObtainedProgram of StudyRequired/Preferredand/orBachelor'sScienceRequiredorBachelor'sArtsRequired
Experience Requirements
Minimum Years RequiredArea of ExperienceRequired/Preferredand/or4 YearsMarketing/Sales/Provider RelationsRequiredor4 YearsPhysician Practice ManagementRequired
Experience: Four years of managed care experience in a physician practice or health system with complex operating environments. Must have knowledge of Payor Contracting processes involving Physician contracts. Payor Contracting processes include negotiation and implementation of payor contracts. Must be familiar with provider credentialing applications; provider database(s) and provider services. Must understand and have in-depth knowledge of health care payment structures and fee schedules. Experience troubleshooting and resolving provider and billing/payment issues with managed care plans. Excellent written and oral communications skills necessary along with superb people skills. Proficient in Microsoft applications and email etiquette. Ability to work independently and set priorities under minimal supervision. Ability to work within the defined values, mission, and vision of the organization.
State of Florida Licensure Requirements
LicensesRequired/Preferredand/orNot Required
Certifications/Registration Requirements
Certificates/RegistrationsRequired/Preferredand/or
US:FL:Fort Myers