Interested in a career with both meaning and growth? Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland works together to fulfill our mission: the health and well-being of individuals and communities entrusted to our care. By joining Parkland, you become part of a diverse healthcare legacy that’s served our community for more than 125 years. Put your skills to work with us, seek opportunities to learn and join a talented team where patient care is more than a job. It’s our passion.
Responsible for coordinating and facilitating assistance to leadership within Provider Relations and Provider Network Development, and is responsible for daily, monthly, quarterly, and yearly deadlines for the health plan. Perform a variety of tasks including those supporting initiatives related to improving quality, grievances and provider remediation, improved access and in controlling unnecessary costs while preserving positive provider relationships. Coordinates the implementation of business changes to simplify operations and improve all provider business experiences with Parkland Community Health Plan.
- High school diploma or equivalent.
- Bachelor's degree in healthcare related field is preferred.
- 4 years of related experience in a business office environment; 2 years of experience of which must be in a Managed Care, Medicaid and/or Community Health environment.
- Experience in provider support, education, relationship management or contracting is preferred.
- Knowledge of claims, billing, coding, or revenue cycle management experience is preferred.
Equivalent Education and/or Experience
- May have an equivalent combination of education and experience to substitute for the experience requirements.
Skills or Special Abilities
- Must be able to demonstrate a working knowledge of personal computers and other standard office equipment, including knowledge of Microsoft Office and Excel software.
- Must be able to demonstrate the knowledge of all departmental policies and procedures that HHSC has mandated to the health plan, and hospital.
- Must be able to demonstrate excellent verbal and written communications skills, as well as organizational skills.
- Must be able to make sound judgement and solve routine and complex problems within the guidelines of established policies and procedures.
- Must be able to complete administrative duties to ensure the department is running efficiently.
- Must demonstrate a positive demeanor, be customer service focused, and be professional in both appearance and approach.
- Able to work successfully in a dynamic, high-growth environment.
- Coordinates projects with Provider Relations and Network Development staff to complete long and short-term objectives for the Medicaid and CHIP program.
- Coordinates and supports Network Development contracting campaigns, Provider Education campaigns, training and education activities involving new programs, policies and procedures, regulatory requirements, etc.
- Supports and facilitates the complaint and appeals process and procedures workflow when provider related requests are requiring department review.
- Creates and maintains operational processes and procedures and supports implementation of policy changes.
- Coordinates Provider Relations triage function.
- Supports frequent provider outreach projects and engagement activities to meet PCHP's business needs, gain market intelligence, and maintain positive network relationships.
- Other duties as assigned.
Parkland Health and Hospital System prohibits discrimination based on age (40 or over), race, color, religion, sex (including pregnancy), sexual orientation, gender identity, gender expression, genetic information, disability, national origin, marital status, political belief, or veteran status.
Nearest Major Market: Dallas
Nearest Secondary Market: Fort Worth
Job Segment: Patient Care, Medicaid, Healthcare Administration, Public Health, Healthcare
- Audio Equipments
- Business Relationship Management
- Business Requirements
- Claim Processing