Provider Relations Manager / Clinical Integration

Hartford HealthCare

$80K — $95K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree or equivalent experience in healthcare preferred.
  • 3-5 years in healthcare operations required; 5-7 years preferred.
  • Proficient in Excel, PowerPoint, and Access; Tableau experience preferred.
  • Familiarity with electronic medical records (e.g., Epic, Athena) preferred.
  • Strong communication, analytical, and interpersonal skills essential.

Responsibilities

  • Create and nurture relationships with clinicians and practices as a key liaison.
  • Educate clinicians on CIN processes, incentives, and quality goals.
  • Provide direct support for service issue resolution, such as payments and authorizations.
  • Conduct annual assessments of clinician engagement and infrastructure capabilities.
  • Develop and implement action plans to address identified gaps based on assessments.
  • Deliver reports and data analysis to support quality goal achievement.
  • Identify and aid in the implementation of best practice improvement programs.

Benefits

  • Opportunity to work closely with healthcare professionals and practices.
  • Engagement with integrated care models and quality improvement initiatives.
  • Access to a collaborative network of CIN teams and resources.
  • Potential for professional development through education and experience in data analysis.
  • Direct impact on clinician success and patient outcomes.
Full Job Description
Position Summary:
Represents the Clinical Integration Network (CIN) and is responsible for facilitating all facets of the clinician/practice relationship with the CIN. Communicates expectations of CIN membership to the clinician/practice and provides direct and indirect support to the clinician/practice to meet these expectations and reach shared quality goals. Ensures the administrative as well as clinical needs of the clinician/practice are identified and addressed.

Position Responsibilities:
Key Areas of Responsibility
1. Creates and fosters relationship with assigned clinician/practice to establish self as recognized liaison between CIN and clinician/practice.
2. Educates clinician/practice on all relevant topics to promote clinician/practice ability to be successful and reach shared quality goals. Topics include but are not limited to: CIN processes/procedures, CIN incentive program details, payer initiatives, quality definitions and goals
3. Provides direct support to clinician/practice to assist with and resolve service issues, including but not limited to payment, authorization eligibility and member matters
4. Assesses each clinician/group, at a minimum annually, to determine engagement, evidence of infrastructure to perform as a CIN member, and ability to meet shared goals
5. Based on annual assessment, works with clinician/practice to implement action plan to mitigate identified gaps
6. Provides concrete reports as well as data analysis to clinician/practice to assist them in successfully meeting shared quality goals roll out and sustain practice improvement programs
7. Illuminates best in class practice improvement programs and assists clinician/practice in implementing these programs to meet shared quality goals
8. Tracks and trends clinician/practice performance to identify areas of opportunity, creating action plans to reach opportunities
9. Partners with Risk Coding and Care Management to ensure alignment around clinician/practice performance and communication
10. Performs all other duties as assigned

Working Relationships:
This Job Reports To: Director of Quality, Integration & Transformation, Integrated
Internal: All CIN teams - Care Management, Health Economics, Managed Care
External: All CIN members - including clinicians and practice staff

Qualifications:

Education
• Minimum: Bachelor's degree or equivalent combination of education, training and relevant experience in lieu of degree
• Preferred: Bachelor's degree in health care related field
Experience:
• Minimum: 3-5 years' experience in practice or health care related operations.
• Preferred: 5-7 years' experience in practice or health care related operations including dealing with physician performance and quality reporting.
Language Skills
• English
Knowledge, Skills and Ability Requirements:
• Ability to support practice changes to discrete and varied audience i.e. Administrators, practice managers, clinicians as needed
• Proficient in Excel, PowerPoint, Access. Experience with Tableau highly preferred.
• Experience with electronic medical records (Athena, EClinical Works, AllScripts, Epic etc) preferred.
• Experience with hospital systems (Cerner, Sunrise, Epic and Premier) is preferred.
• Excellent communication, analytical, presentation and interpersonal skills
• Ability to understand and convey complex information to many difference kinds of people is an absolute requirement with demonstrated ability to work as a member of a team
• Competence in quality improvement and data interpretation
• Familiarity with case management and care coordination processes; experienced and skilled in working with interdisciplinary teams
• Ability to innovate to achieve the organization's goals
• Comfortable using and/or learning to use databases, reporting software, electronic medical record
• Exhibits leadership in demonstrating to staff how to embody the patient-centered goals of the organization, and in embracing change, where appropriate

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