What are the responsibilities and job description for the Patient Relations Manager (West Birmingham, AL) position at Complete Health?
JOB SUMMARY:
Under the direction of the Value Based Care (VBC) Leadership the Patient Relations Manager oversees the efficiency and quality of duties of the Client Relations Team (Patient Relations Coordinator) and works closely with VBC Patient Advocates, ensuring alignment of accurate VBC membership patient demographics and follow up with Medicare Advantage plans (AL and FL). Develops training and executes plans to optimize VBC conversions of existing membership (e.g., Duals), and maintains accuracy of VBC Member Optimization patient list categories: Unattributed, Unassigned, Unmanaged, Drops and Duals.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Develop plan for Duals and clinic-specific opportunities
- Coordinate scheduled outreach efforts for point-of-care opportunities
- Utilizing Monday.com/PowerBI and Athena scrubbing
- Establish daily routine for patient outreach opportunities
- Organize and develop a plan to manage Member Optimization VBC patient list categories
- Utilize Monday.com to manage Member Optimization lists and provide monthly status updates
- Work closely with Medical Economics to develop accurate data reports
- Communicate progress to the VBC leadership
- Schedule clinic visits to provide education and resources for VBC plans
- Assess and evaluate areas for improvement for capturing accurate patient information
- Manage patient engagement and retention through incoming VBC patient inquires
- Assist in connecting VBC patients with agents
- Works closely with Field Marketing Organization (FMO) per market to drive membership
- Assess and coordinate brokers and independent agent(s) engagement within each clinic
- Works closely with Contracting/Payor Relations team
- Membership Optimization Reporting:
- Member Optimization VBC patient list categories
- Evaluation of point-of-care outreach effectiveness
- Duals outreach progress from Monday.com
- In-Clinic Conversions:
- Fee-for-Service (FFS) conversions
- Duals enrollments (Medicare/Medicaid)
- Step-Up conversions of existing VBC MA into a SNP plan
- Net-New conversions
- Agent/Broker opportunities and building relationships
- Provides communication with clinic staff and management to optimize efforts across all clinics
- Participates in pertinent meetings and workshops as directed
- Interacts with respect and in a professional manner with patients, staff, and external customers
- Follows HIPAA and OSHA Standards and guidelines
- Maintains HR compliance and procedures
- Ensures patient satisfaction by providing excellent service putting "patients first always"
- Other duties as assigned
- Not a remote position
- Pay range: $50,000/annually
- Location: 832 Princeton Avenue SW, Birmingham, AL 35211
EDUCATION AND EXPERIENCE REQUIREMENTS:
- High school diploma or a GED is required
- Previous leadership role experience is required
- Service-excellence oriented in a professional setting preferably Healthcare (e.g., primary care) or health-plan support of Medicare Advantage to doctors' offices and staff is required
- Minimum of 2 years medical clinic front office and/or medical assistant experience is required; or equivalent combination of education and experience
- Knowledge of Medical Insurance is required
- Knowledge of various Medicare plans including Medicare Advantage (MA) HMO, PPO, C-SNP, D-SNP; Duals) is required
- Ability to guide patients to services both within the clinic and within their health plan, as well as outside agencies is required
- Demonstrated experience on VBC member roster accuracy preferred
- Athena EHR experience preferred
- Able to effectively utilize an electronic health record is preferred Strong computer skills and proficiency in internet software and knowledge of Microsoft Office products required
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MINIMUM REQUIREMENTS
- Strong coordination and organizational skills
- Experience in coaching and supporting peers
WORKING ENVIRONMENT
The position requires climbing, stooping, kneeling, crouching, reaching, standing, lifting, grasping, feeling, talking, hearing, repetitive motions, and finger use. Pushing and pulling are occasionally required. Use of a computer, keyboard, and telephone along with various office machines is an essential part of the job.
DISCLAIMER
The above statements are intended to describe the general nature and level of work being performed by the Patient Relations Manager. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. The Patient Relations Manager may be required to perform duties outside of their normal responsibilities from time to time as needed or as directed by supervision.
Salary : $50,000
