What are the responsibilities and job description for the Provider Consultant position at PBACO Holding LLC?
Job Description
To act as a key liaison between healthcare providers and organizational initiatives, translating claims and payer’s data into actionable insights for shared savings, population health improvement, and value-based care outcomes.
Key Responsibilities
- Advocate for primary care independence, solutions and practice longevity.
- Translate applicable claims and payer data into actionable strategies for shared savings and improved outcomes.
- Serve as the primary point of communication with assigned practices, offering direct support, guidance and solutions.
- Manage and guide practices to achieve population health and value-based care initiatives. Like: Panel Retention, IP & ED admissions reduction, extended hours and access to care, among others.
- Conduct at a minimum biweekly meeting with practices and provide detailed recaps. That specify areas of opportunities and collaborative solutions to improve patients’ outcomes. Reaching 80% Pass Rate Monthly.
- Analyze data to identify workflow improvement opportunities and deliver actionable recommendations.
- Ensure timely and accurate report turnaround and delivery. While upholding the intended message and goals.
- Monitor and update Salesforce (SF) and other tracking systems to reflect ongoing touchpoints and follow-ups.
- Provide continuous education and training for practice staff and applicable clinicians.
- Conduct quality reporting initiatives to ensure compliance with population health and improvement of goals.
- Engage in market research to identify trends and their impact on healthcare delivery.
- Develop and implement innovative care solutions and resources.
- Foster strong relationships with stakeholders and ensure adherence to compliance measures.
- Escalate unresolved provider issues to Market Managers (MM) or direct supervisor when necessary.
- Interdepartmental communication point person for multidisciplinary teams including support departments.
- Expected to be in all needed meetings, in person or virtual (with camara on) as instructed by supervisor, and be ready to collaborate, present, learn and provide value. Like: Physician Advisor Meetings, POD Meetings and All Members Meetings, among others.
- Touch Reports and dailies submitted via Salesforce must be submitted by 10 am the next day.
- Participate in monthly/quarterly ride along with supervisors.
Required Skills and Competencies
Technical Skills
- Proficiency with Microsoft programs, such as Excel, Word, Power point and Power BI, among others.
- Proficiency in CRM’s such as Salesforce (SF), Workflow management tools, and Electronic Medical Record (EMR) systems.
- Strong analytical skills for interpreting healthcare data and trends.
Soft Skills
- Exceptional time management and organizational abilities.
- Assertive and persuasive communication.
- Goal-oriented and adaptable to dynamic environments.
- The staff must be able to work independently as a telecommuter and attend off-site meetings, including overnight stays.
Competency
- Collaboration and relationship management.
- Innovative problem-solving and resourcefulness.
- Stakeholder management and the ability to influence outcomes.
Decision-Making Authority
- Authorized to manage and resolve practice-level issues independently.
- Empowered to escalate unresolved issues to Market Manager of Operations or direct supervisor
- Responsible for setting and monitoring goals for assigned practices.
Reports To
Market Manager of Operations or specified direct supervisor.
Required Experience and Education
Experience:
- Minimum 3 years of experience in healthcare operations, consulting, or a related role
- Familiarity with HIPAA regulations and quality standards in healthcare settings.
- Payer experience in negotiation, utilization management or quality improvement.
Education:
- Bachelor’s degree in healthcare administration, Business, or a related field.
Preferred Qualifications:
- Master, MBA or similar.
- Knowledge and understanding of the dynamics of Managed Care environment, including capitation and reimbursement structure.
- Past experience managing providers practice or healthcare facility operation.
Physical Demands/Requirements:
- The position requires driving for extended periods of time, as well as walking to and from provider offices potentially up and down stairs.
- May lift company equipment ~10 Lb.
- Need to position to be on site or virtually.
Endocrinologist | Full-Time | Monday–Friday | Outpatient Only
The Provider Finder -
Ocala, FL
General Neurologist – MD | No Call | Full-Time Permanent | Ocala, FL
The Provider Finder -
Ocala, FL
Homecare Provider
Ohana Community Care, LLC -
Palatka, FL