What are the responsibilities and job description for the Provider Relations & Contracting Specialist position at Adventist Health?
Nestled between Burbank and Pasadena, Adventist Health Glendale is one of the area’s leading healthcare providers. We are comprised of a 515-bed hospital, two urgent cares, home care services, comprehensive cardiology care and a vast scope of services located in the San Fernando Valley. We are committed to the development and empowerment of our nurses and have received Magnet designation from the American Nurses Credentialing Center. Glendale is known for its urban living, with easy access to dining, entertainment, shopping, amusement parks and outdoor recreation. Adventist Health Glendale is proud to be part of the thriving, diverse community since 1905.
Job Summary:
Develops and maintains positive provider relationships with community providers by regular on-site visits, communicating administrative and programmatic changes, and facilitating, education and the resolution of provider issues. Assists in the full range of provider relations and service interactions within the Adventist Health Plan and Adventist Health care network. Coordinates with contracted Management Service Organization (MSO) to assist with provider inquiries.
Job Requirements:
Education and Work Experience:
- Associate’s Degree in healthcare/business or equivalent combination of education/related experience: Required
- Bachelor's Degree in business administration, health care administration or other related field: Preferred
- Three years' experience in health care field interacting directly with providers: Preferred
- Managed care experience: Preferred
Licenses/Certifications:
- Valid Driver’s License (DL) and must be at least 21 yrs of age or older: Required
Essential Functions:
- Develops and manages trusting relationships with key providers by coordinating and facilitating meetings. Completes new provider orientation for all applicable product lines. Exhibits understanding and sets priorities to handle multiple tasks simultaneously, and designs work plans to track progress, resolve issues, and efficiently and effectively see tasks to completion. Coordinates with contracting manager on network needs to perform recruitment.
- Coordinates with other departments to ensure provider compliance with contractual obligations. Ensures provider education and communication compliance requirements are met and participates in activities related to plan compliance. Collaborates with partners and various departments on network expansion efforts to ensure provider onboarding is completed.
- Serves as a knowledge and resource expert regarding provider issues impacting provider satisfaction. Coordinates prompt resolution to provider issues through direct contact with providers and internal management.
- Achieves calls/outreach and frequency goals to establish consistent and strong relationships with provider offices. Assists in monitoring of provider performance and communicating feedback to improve quality of service. Performs outreach, monitoring and resolution of provider inquiries.
- Conducts site visits to service providers, resolves issues, collects credentialing information, and participates in quarterly joint operations meetings.
- Performs other job-related duties as assigned.
Organizational Requirements:
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.
