What are the responsibilities and job description for the In-House IPA Representative position at MedPOINT Management?
Job Description
Job Description
Under the general direction of the Provider Network Operations (PNO) – Provider Network Management Supervisor, the In-House IPA Representative serves as the liaison between the IPA clients, IPA client’s contracted providers and health plan(s). They will be responsible for the executing the provider onboarding, update, and termination processes for the MedPOINT Management (MPM) managed client IPAs. The In-House IPA Representative ensures the timely and accurate update of provider information system / database, resolution of providers’ issues, State / health plan reporting, and improving all provider business experiences with their assigned IPA. They will interface with PNO, Credentialing, Utilization Management (UM) and other MedPOINT Management (MPM) departments to facilitate numerous processes, including but not limited to Credentialing assistance, UM coordination, contracting support, health plan communications, and Provider communications.
Duties and Responsibilities
- Maintain frequent, timely and productive communication with IPA clients, providers, health centers, and health plans
- Performs PNO triage function; addresses issues and requests raised / submitted by providers and routes communications to the appropriate teams for successful resolution
- Assist in research of provider-related issues including demographic information, contracting status, credentialing status, claim issues and status in MPM client database
- Ensure accuracy among assigned IPA profiles within EZ-CAP database
- Maintain timely and thorough communication with PNO Rate Configuration and Contracts, Credentialing and Compliance Teams on terminations and contract status changes for appropriate rate adjustments and recruitment, if needed
- Complete / Oversee special projects as they arise (e.g. ad-hoc health plan, IPA clients or provider requests)
- Participate in assigned IPA client’s standing and ad-hoc meetings as needed
- Ensure HIPAA compliance is always observed / performed
- Understand and follow the MPM Employee Handbook policies and procedures
- Perform additional duties / assignments as needed
Minimum Job Requirements
Skills and Abilities
MedPOINT Management , a large MSO in the San Fernando Valley, offers competitive salaries and benefits in a collaborative working environment. For immediate consideration of this position, please e-mail your resume and salary requirements to
