Title : Provider Relations Specialist - Based in Miami, Florida
Company : Established Accountable Care Organization ( PCP and IM)
Industry : ACO, MSO or Medicare Adv Plan experience
Full time - Monday- Friday
Field Based Rep - 3 travel days within the territory and 2 days in remote office
Location : Must live within 30 minutes of Miami- Dade County 33165 and surrounding areas
- Must have at least 2 years of experience with providers in managing the value based care reports to improve CMS savings
The Provider Relations Representative is responsible for fostering a strong and satisfied network of healthcare providers in a designated area. They serve as the main liaison between practices, the company, and health plan partners. Their main focus is to work closely with providers to improve performance in areas like cost reduction, revenue optimization, quality enhancement, and provider satisfaction for Medicare patients.
Requirements
2 years in Provider Relations, Network Management (field based or office based exp) in an ACO. MSO or Medicare Adv PlanExperience in provider education, performance review, improvement plans and account managementYOU MUST have experience discussing these reports with the provider such as HEDIS, CMS Star Rating System, and most importantly the (MLR )Medicare Loss Ratio, (MRA) Medicare Risk Adjustment, and (RAF) Risk Adjustment Factor.Bachelor's degree a plus, not requiredValid driver's license and reliable transportation requiredAbility to travel - 3 days in the field / 2 admin days remote (Full-time M- F)- in Miami, Florida only- local experienceStrong interpersonal and communication skillsExperience in presentationsAnalytical and problem-solving skillsTime management and organizational skillsAttention to detail and reliabilityProficiency in MS Office programs and ExcelBilingual in Spanish and English, for Miami territoryKey Responsibilities :
Provider Education and Support : Provide comprehensive education and tools to help providers meet quality and financial goals.Accountability and Performance : Understand and improve the financial performance of practices, ensuring they meet key performance indicators.Provider Training and Orientation : Conduct orientation sessions and ongoing training for providers and their staff.Provider Retentio n : Work to retain providers by ensuring their satisfaction with the organization.Provider Collaboration : Facilitate meetings to enhance patient outcomes and operational efficiencies.Performance Improvement Plans : Develop, implement, and monitor improvement plans for provider groups.Provider Negotiations : Negotiate contract terms and analyze proposals.Communication and Issue Resolution : Maintain open communication channels and resolve issues promptly.Strategic Planning : Collaborate to implement strategic interventions.Onsite Provider Visits : Spend most of the workweek visiting providers, with clear objectives for each visit.Engagement with Specialists : Focus on engaging high-quality specialists and improving coordination of care.Compensation :
Base salary $70k-$80K ( possible bonus) plus expense reimbursement, car allowance, 18 days PTO, fully subsidized health benefits, Holidays, 401k
Please submit your resume in a word document. If you are a match, a ttg Talent Solutions recruiter will contact you by phone, email or text. Please monitor your inbox. Please only apply if you match the requirements and live in Miami, Florida or within 30 minutes.
At ttg, “We believe in making a difference One Person at a Time” ttg OPT.
Salary : $70,000 - $80,000
