Provider Support Coordinator

Arizona

Remote position available

Job Description

We are seeking a Provider Support Coordinator who will work remotely (or from the Phoenix office if preferred) and resides in Maricopa County, Arizona. This position will travel 60-70% throughout Maricopa, Gila and Pinal Counties in Arizona.

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. Responsible for maintaining relationships with providers, clinics and provides on-going support and education to improve upon existing services offered by providers. Works both internally and externally to help ensure improved population health of our members. Provides onsite support in provider offices for scheduling members.

Essential Functions

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  • 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

Title

Provider Support Coordinator

Grade

19

Job Family

Quality Group

Country

United States of America

FLSA Status

United States of America (Non-Exempt)

Recruiting Start Date

8/28/2019

Date Requisition Created

8/20/2019

Work Experience

Managed Healthcare, Quality

Education

Associates: Healthcare (Required), Bachelors: Healthcare

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

Required Qualifications

  • 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 

Preferred Qualifications

  • 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 

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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