Manager of Network Integration

Company: Kelsey-Seybold Clinic
Location: Pearland
Posted on: November 21, 2022

Job Description:

Overview
Kelsey-Seybold Clinic, a Houston tradition in patient-centered care, is a multispecialty clinic with over 25 locations and comprises more than 500 physicians providing primary and specialty care in a collaborative manner.
With 55 different clinical and non-clinical specialties, you can design a career path at Kelsey-Seybold Clinic that allows you to grow your future in a completely new direction.
Kelsey-Seybold Clinic is changing the way health cares. - -
Responsibilities
The Manager of Network Integration is responsible for oversight of the Sr. Provider Relations Liaison team and their efforts towards establishing and maintaining strong 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. Responsibilities include developing educational instruction and ensuring support to physicians and their staff. The Senior Provider Relations Liaison will be the main point of contact for the respective providers and will routinely visit physician's offices for issues concerning the achievement of provider satisfaction, medical cost targets, network growth and/or efficiency targets. This role includes 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.
Qualifications
Manager of Network Integration
Location: Pearland Administrative Office -
Department: Network Development
Job Type: Full Time -
Salary Range: - $97,219.20 to $120.099.20 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)
EDUCATION REQUIREMENTS & EXPERIENCE REQUIREMENTS
(A = basics; B = preferred)
Education
A. Bachelor's Degree (1-year experience equivalent to 1 year of college)
B.
Graduate degree in Business or Healthcare Administration.
Experience
A.
5+ years contract negotiation experience at a health plan or medical group.5+ years' experience in provider relations or network management with a demonstrated ability to perform network development and/or provider relations.Experience with developing provider and/or facility networks. Must possess a knowledge of claims processing, managed care plan benefits and utilization management policies and procedures.
B.
Demonstrated negotiation skills and ability to interpret provider contracts and regulatory contracts.3+ years of experience in Medicare/Commercial products5+ years' experience in applicable healthcare administrative operations
Licenses
A.
Valid Texas Driver's License and ability to travel. Must own or lease a working vehicle and be able to travel daily within the Greater Houston area.
B. -
Communication
A. -
B. -
Special -Skills
A. Demonstrated knowledge of CPT and ICD-10 coding and prior experience with reimbursement methodologiesProficient with Microsoft Word and ExcelAnalytical and problem-solving skills; ability to communicate effectively in writing and verbally
B.
Proficient with Excel and/or PowerPoint
Other
A. Ability to work in a fast-paced environment; demonstrated ability to perform multiple concurrent tasks with minimal supervision and meet deadlinesDemonstrated public speaking and presentation skillsB.
Capable of managing a variety of complex issues while driving momentum of key projects
WORKING ENVIRONMENT
Office

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