Network Management Associate - Campbell, United States - HCA Healthcare
Description
Salary Estimate:
$ $ / year
Learn more about the benefits offered for this job.
Introduction:
Benefits:
HCA Healthcare, offers a total rewards package that supports the health, life, career and retirement of our colleagues.
The available plans and programs include:
- Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
- Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, longterm care coverage, moving assistance, pet insurance and more.
- Free counseling services and resources for emotional, physical and financial wellbeing
- 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
- Employee Stock Purchase Plan with 10% off HCA Healthcare stock
- Family support through fertility and family building benefits with Progyny and adoption assistance.
- Referral services for child, elder and pet care, home and auto repair, event planning and more
- Consumer discounts through Abenity and Consumer Discounts
- Retirement readiness, rollover assistance services and preferred banking partnerships
- Education assistance (tuition, student loan, certification support, dependent scholarships)
- Colleague recognition program
- Time Away From Work Program (paid time off, paid family leave, long
- Employee Health Assistance Fund that offers free employeeonly coverage to fulltime and parttime colleagues based on income.
_ Note:
Eligibility for benefits may vary by location._
We are seeking a(an) Network Management Associate for our team to ensure that we continue to provide all patients with high quality, efficient care.
Did you get into our industry for these reasons? We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do.
We want you to applyJob Summary and Qualifications:
The
Network Management Associate is responsible for independently focusing on PPMSI's relationship with PPMSI's delegated contracted physician networks.
What you will do:
- Work with client to insure adequate physician network retention, expansion and recruitment.
- Responsible for provider education regarding services, policies, and procedures of PPMSI.
- Responsible for handling daily provider inquiries, including capitation and reimbursement issues.
- Assist in physician communication programs and strategy.
- Responsible for maintaining strong relationships with contracted Health Plans (HMO and PPO).
- Communicate with payors and network providers, both orally and written, in association with operational and contractual related issues
- Serve as client liaison and advocate with all departments at PPMSI.
- Assist in client related projects.
- Assist in identifying issues, problems, and areas where PPMSI performance could be improved.
- Represent PPMSI at physicians' offices, contracted health plans, and committees when necessary.
- May attend client meetings where necessary to facilitate communication of information of PPMSI.
- Develop and present educational pieces at network provider meetings.
- Assist in periodic statistical performance reporting to clients.
- Assist Network Management and Member Services Manager with the development of strategic plans for servicing network physicians.
- Develop, recommend, and implement new policies and procedures for PPMSI when appropriate.
- Play a key supportive role in Quality Initiatives.
- Perform other job as assigned.
KNOWLEDGE, SKILLS AND ABILITIES:
This position requires the following minimum requirements:
- Advanced knowledge of managed care market, strategies, and physician compensation models
- Working knowledge of medical group/IPA operations
- Excellent verbal and written communication skills
- Excellent public speaking and interpersonal skills
- Able to present oneself professionally and have the ability to address large groups of people in educational forums
- Strong research and analytical skills
- Able to research complex contractual documents for interpretive purpose and utilize critical thinking skills
- Efficient in Word, Excel, Power Point, and Vision
- Ability to prioritize
- Ability to analyze complex situations and accurately identify key components
- Handle multi tasks simultaneously
- Willingness to travel locally
- Knowledge of claims payment systems
- Possess excellent problemsolving skills and is able to identify and adapt to shifting priorities
What you will need:
EDUCATION:
- Bachelor's degree in busine
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