Southwestern Health Resources (SWHR CIN) seeks to hire a Provider Concierge Representative to work Full Time supporting the Care N’ Care department.
Please note: Southwestern Health Resources Clinically Integrated Network (SWHR CIN) is an affiliated company of Texas Health and UT Southwestern. If hired for this position, you will become a SWHR CIN employee rather than a Texas Health or UT Southwestern employee.
After SWHR Covid protocol ends, this position will office at the SWHR Corporate Headquarters, 1603 LBJ Freeway, Farmers Branch, Texas 75234
Local 80% travel to Provider Offices to conduct Provider site visits (when permitted)
Salary range is Min $20.70 - Max $31.79 – based on relevant experience
• Full Time, 40 hours
Establish and maintain strategic partnerships with providers. Communicates the vision and goals of the health plan to support the development of the highest possible provider partnerships.
Collaborate with providers, especially primary care and their staff to ensure their practice improves their RAF and Quality results.
Explain reports to providers and their staff that directly drive results related to health plan initiatives.
Shares best practices with providers’ exercise of discretion, judgment and make recommendations for actions that will drive results.
Create partnerships with IPA's to maintain open communication with extended providers.
Flexible schedule and availability to attend business meetings.
Provide professional, timely and accurate direct customer service to internal and external customers.
Provide Customer Service to Providers
Provide health plan updates, education, resources, training, guidance to providers and their staff.
Be creative, contribute to developing, implementing provider education materials and resources.
Attend to provider issues/concerns in a timely manner.
Conduct health plan Welcome Orientations to new providers plus their staff.
Be the primary contact for participating providers in the network.
Strive for provider satisfaction with health plan overall.
Resolve complex provider issues
Identify issues and how it may affect other health plan department operations.
Contribute to identifying the root cause, problem solve, make decisions, interpret data, organize and analyze.
Escalate any trends identified and share findings with department.
Collaborate with other departments to address any complex issues in an attempt to resolve them in a timely manner.
Maintain open communication with providers on status of their issues.
Track and document daily activities in a timely manner
Document in systems daily activities and communication with internal/external customers accurately, timely and clearly.
Participate with other departments on health plan initiatives to improve provider performance.
Contribute to creating provider education materials and resources.
Getting providers to actively participate in health plan programs/projects.
Coordinate with provider offices to review reports.
The ideal candidate will possess the following qualifications:
Bachelor's Degree in Healthcare, Marketing, Communications, Public Relations, Business or Relevant Area of Study Preferred
2 years’ experience in Healthcare, Managed Care, Insurance, Provider Relations or Account Management Required
1 year Medicare Advantage experience Preferred
1 year Claims Billing/Coding knowledge Preferred
Demonstrate a general knowledge of healthcare delivery systems;
Able to interpret reports, prioritize assignments, evaluate the accuracy of data and effectively communicate results;
Ability to create action plans to support the reports in an effort to drive results;
Must be able to multitask, participate in projects, identify priorities, problem solve, make decisions, organize and analyze workflow, write, plan, use math method formulas, and simple arithmetic;
Have the ability to communicate professionally in writing and verbally with internal and external customers;
Creative in developing education materials for providers;
Able to develop and maintain provider partnerships for the health plan;
Ability to exhibit confidence when working directly with physicians and their staff;
Flexible schedule and availability to attend business meetings;
Must be able to operate general office equipment including but not limited to computer, phones, related media and information devices;
Possess intermediate knowledge of Microsoft Word, Excel, Power Point, QNXT, Facets, Ring Central and Salesforce;
Dependable, self-motivated, creative, solution focused and exhibits initiative;
Remain composed in emotionally stressful situations at all times
Ability to work well on a team and independently;
Must be able to provide excellent customer service to internal and external customers;
Reliable transportation and driver's license.
Working Outdoors 1-33%
- Location: Dallas, Texas, United States
- Job Field: Clerical/Admin
- Travel: Yes, 75 % of the Time
- Shift: Day Job
- Schedule: Full-time
- Pay Basis: Hourly
- Minimum Salary:
US Dollar (USD)
- Market Salary: US Dollar (USD): 26.00
- Maximum Salary :
US Dollar (USD)