Provider Relations Representative
3 weeks ago
This position will be focused on pediatric practices.
Position Summary
The Provider Relations Representative (PRR) serves as a point person for practices, helping them to succeed in providing high quality, patient-centered care. This position works collaboratively with Community Care of North Carolina (CCNC) central office, Community Care Physician Network (CCPN) and assigned region[s] to provide the necessary education, tools, and resources to our practices that serve our member populations.
Essential FunctionsServes as point person for practices through the following functions:
- Proactively develops and maintains strong provider relations to increase participation and engagement with the region, CCNC, and CCPN through regular visits and other forms of outreach
- Provides education to providers with tools and resources to meet needs of the population through best practice guidelines, practice management support, and/or other appropriate resources in order to promote quality and cost-effective outcomes
- Actively conducts recruitment outreach to enroll eligible practices in CCPN and CCNC efforts and/or initiatives.
- Utilizes basic data comprehension skills to identify individual provider needs, aggregate trends and prioritize work with practices through critical data analysis.
- Provides basic data analysis, interpretation and graphing as required to meet practice needs
- Delivers provider and practice education, including training on tools (e.g. Practice Perfect Suite of Tools), new practice orientations, refreshers, in- services on regional and CCNC programs and initiatives, and other information as needed
- Promotes and attends practice manager and provider meetings, as appropriate, to ensure understanding of information for dissemination to PCPs
- Networks with providers and other important contacts for regional operations, CCNC, and CCPN
- Maintains updated practice information in designated database on a regular basis to include, but not limited to, number of physicians, operation hours, type of medical record system, etc.
- Documents practice outreach and interactions in designated database in a timely manner according to documentation guidelines
- Fosters relationships and maintains communication with multiple disciplines including regional care management and pharmacy teams, CCNC central office staff, CCPN staff, PHP representatives, DHHS/DHB, and regional/local Managed Care Representatives
- Maintains member and family confidentiality in accordance with HIPAA
- Represents the organization in a professional manner at all times
- Travel using personal vehicle will be required within the region and/or the State
- Other job duties as required
- Bachelor’s Degree highly preferred, OR Associates Degree with two years of equivalent work experience, OR minimum of five years of equivalent work experience
- Experience in communications & marketing
- Experience in data analysis & interpretation highly preferred
- Experience in working with medical practices is highly preferred
- Experience in quality reporting/EHR technical assistance is highly preferred
- Maintain a valid driver’s license with current auto liability insurance
- Embrace our corporate culture, including our vision, mission and values
- Effective communicator who utilizes academic detailing (AD) skills; able to present oral and written information clearly, concisely and in a timely manner
- Displays Emotional Intelligence (EI) skills through ability to respond versus react, accept and utilize feedback, and maintain positive, respectful work relationships through self-management and strategic relationship building
- Forward thinking and solution-oriented; able to turn challenges into opportunities and take actions to improve business processes
- Able to manage multiple tasks/projects, including prioritizing duties, meeting deadlines and providing on-time responses to management, supervisor and co-worker requests
- Demonstrate a commitment to accuracy and thoroughness
- Punctual, reliable, able to begin work as scheduled and attend mandatory meetings
- Basic knowledge of Medicaid, healthcare payment, and governance
- Analytical skills, sound judgment and self-direction are necessary as independent decisions and problem solving are required
- Computer skills, including fluency in Microsoft Office applications (Word, Excel, PowerPoint, etc.)
- Familiarity with data analysis and interpretation; ability to appropriately communicate results verbally and in writing based on target audience as determined by specific functions of the role
- Utilization of QI methodologies such as the Model for Improvement with rapid cycle PDSAs and other evidence-based strategies and techniques
- Comfort with public speaking in front of people from multiple disciplines
- The job environment is a combination of office, work at home, and medical facility environments
- Exposure to general office conditions as well as communicable diseases could occur
- Exposure to general office and household conditions including minor physical inconveniences, discomfort in the work setting, or sitting for moderate periods of time
- Travel within the region and/or the state
- There is occasional lifting of 20-30 pounds necessary to complete a task
- Evening and weekend work may be required with advance notice and corresponding adjustment in work week schedule
The above statements are intended to describe the general nature and level of work performed in this position and are not to be construed as an all-inclusive list of duties, skills and responsibilities. In signing this job description, I confirm that I understand and am able to fulfill the terms of the position as set forth above.
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