Job DescriptionWe are seeking candidates who reside in either Brevard, Orange, Osceola or Seminole County, Florida as they will work remotely and travel 60-75% throughout those counties.
The Provider Support Coordinator acts as the front-line liaison between the health plan and provider offices and promotes change in behaviors and provides support to high volume clinics and providers. He/she is responsible for maintaining relationships with providers, clinics and provides on-going support and education to improve upon existing services offered by providers. He/she works both internally and externally to help ensure improved population health of our members. He/she provides onsite support in provider offices for scheduling members.
- Supports practice implementation of care coordination and care management.
- Identifies action plans for providers to implement to improve cost, quality and the patient experience.
- Participates in design, development, and implementation of community learning forums.
- Actively participates in developing program recommendations and internal action plans.
- Assists with member survey.
- Supports Performance Improvement Projects (PIPs).
- Supports Plan Do Study Act (PDSA) cycle improvement projects.
- Supports the efforts of providers and practice teams on office-based care delivery interventions resulting in cost of care savings and improved health outcomes for patients.
- Provides education for practices to develop expertise with metrics and data review for quality improvement.
- Participates in various community and multi-department committees to assure effective program implementation.
- Coordinates on-site support in provider offices for completion of clinical interventions (Clinic Days).
- Schedules members for Clinic Days, post discharge, follow up.
- Provides member education.
- Verifies insurance.
- Improves the effectiveness and efficiencies of provider practices.
- Obtains and analyzes quality metrics and reports for care opportunities.
- Provides on-site support at provider offices to administrative staff.
- Performs other duties and projects as assigned.
General Job Information
TitleProvider Support Coordinator
Job FamilyQuality Group
CountryUnited States of America
FLSA StatusUnited States of America (Non-Exempt)
Recruiting Start Date6/6/2019
Date Requisition Created6/4/2019
Work ExperienceManaged Healthcare, Quality
EducationAssociates: Healthcare (Required), Bachelors: Healthcare
License and Certifications - Required
License and Certifications - Preferred
Other Job Requirements
- Demonstrated experience in leading significant cross-functional work
- Excellent knowledge of HEDIS, NCQA, Medicare Stars and Medicaid
- Conceptual and in-depth knowledge of the healthcare industry
- Ability to manage relationships with an emphasis on internal and external mid-level relationships
- Ability to work across all levels of the organization, including working with executive audiences, vendors and the government as a customer
- Demonstrated ability to select and implement strategies that are most likely to be successful
- Minimum two years experience in managed care
- Associates degree in healthcare or related discipline such as coding
- Two plus years of experience in quality management
- Demonstrated understanding of healthcare industry standards, HEDIS and NCQA
- Proficient in Microsoft Office tools
- Strong analytical skills and strategic thinking
- Strong communication skills, both verbally and written
- Ability to interact effectively with business owners, senior management, and peers across the organization
- Ability to travel regionally 60-75% in field
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.
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