Facility: VIRTUAL-GA

Job Summary: Build and maintain strong relationships with assigned WMG, ACO, IPA & WCP physicians and office staff. Facilitate and conduct site visits with assigned practices. Provide education and support to physicians and staff regarding Managed Care contracts. Resolve all operational issues in a timely manner. Coordinate educational sessions between Managed Care plans and the offices. Work closely with Contract Managers to ensure physician office concerns with Managed Care contracts are escalated. Work closely with all Managed Care staff on a daily basis. Core Responsibilities and Essential Functions: Act as a liaison between physician offices and Managed Care plans - Prepare and develop educational material, quick reference guides, etc.to assist physician/office staff. - Communicate and educate physician offices regarding new processes, policies and procedures with managed care plans. - Facilitate timely resolution of operational issues received from physician offices. Facilitate and conduct regular site visits to all assigned physician offices - Build and maintain strong relationships with physicians and office staff. - Establish and maintain open line of communication with physicians and office staff. - Provide one on one, face to face education and support to physicians and office staff. Attend and participate in regularly scheduled educational meetings - Provide updates for outstanding issues from previous JOC. - Prepare and present new items as needed for discussion. - Escalate high dollars. Coordinate and attend meetings. - Educational meetings. - Orientation/re-orientation meetings with payors. - Others as needed. Payor Directories - Notify Contract Managers of incorrect demographic changes. - Confirm new Physician loads in Payor directories. Required Minimum Education: Bachelor's Degree Preferred or In lieu of degree, four to six additional years of relevant experience Required Required Minimum License(s) and Certification(s): All certifications are required upon hire unless otherwise stated. Additional License(s) and Certification(s): Required Minimum Experience: Minimum 4 years managed care environment or other health care environment requiring communications with physicians regarding claims and reimbursement rates Required Required Minimum Skills: Self directed, ability to work autonomously and prioritize multiple assignments in a fast paced environment without direct supervision. Very strong organizational skills. Must have a clear understanding of functional elements of a high quality managed care program, i.e., utilization management, credentialing, quality improvement, member services, contracting, health care finance and claims. Must be computer literate in word processing, database and spreadsheet programs. Strong communication skills in order to maintain a professional relationship with providers. Should be computer conversant, literate in database and have the ability to analyze data and confirm output integrity. Must be able to work in a team oriented environment and have excellent organizational,writing and oral communication skills. Knowledge of managed care contracting. Familiarity with CPT coding and medical terminology.