Healthcare Network Liaison Specialist
6 days ago
This role serves as a liaison to SCFHP's network of providers, hospitals, sub-acute facilities, and health systems. The successful candidate will provide exemplary customer service and training to all providers in compliance with state and federal regulatory requirements.
Key Responsibilities- Represent SCFHP in the provider community through internal and external meetings and events.
- Serve as primary provider liaison and subject matter expert, responding to complex provider questions and complaints/problems via telephone and in person.
- Assist providers in navigating SCFHP operations, provider network systems, compliance, and regulations.
- Communicate clearly and concisely with providers at all levels, capturing and documenting issues and feedback, and conveying information to other departments and leadership when necessary.
- Collaborate with Provider Network Management and MLTSS team members to coordinate resolution of operational issues and cross-departmental improvement efforts.
- Develop and monitor the provider network to identify issues related to network adequacy and access, taking action to improve quality access to medical services and member satisfaction.
- Create and deliver SCFHP provider orientation and training within established timeframes, developing annual provider communication plans, including site visits, trainings, and meetings.
- Maintain knowledge of SCFHP's departmental functions and processes to research and identify operational issues.
- Build and maintain expertise in managed care, SCFHP policies, and procedures, incorporating knowledge into the development of provider training and communication tools.
- Bachelor's Degree in Social Sciences, Business, or related field, or equivalent experience, training, or coursework.
- Minimum three years of experience in a managed care setting, provider organization, or health policy organization.
- Ability to build and maintain professional relationships with providers and manage complex problems.
- Knowledge of Medi-Cal, Medicaid, and/or Medicare managed care programs is desired.
- Excellent communication skills, including presentation and leadership abilities.
- A valid California driver's license and acceptable driving record are required for offsite meetings or events.
- Proficient in adapting to changing situations, meeting accuracy and timeline requirements, and maintaining confidentiality.
- Working knowledge of computer software applications, including Outlook, Word, PowerPoint, and Excel.
$65,000 - $90,000 per year, depending on experience and qualifications.
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