Dignity Health

  • Network Relations Specialist

    Job ID
    2018-46976
    Employment Type
    Full Time
    Department
    Clinical Integration
    Hours / Pay Period
    80
    Facility
    Dignity Health Management Services Organization
    Shift
    Day
    Location
    Phoenix
    State/Province
    AZ
    Standard Hours
    Mon-Fri (8-5 PM)
    Work Schedule
    8 Hour
  • Overview

    The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.

     

    Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.

    Responsibilities

    The Arizona Care Network (ACN) is a clinically integrated (CI) physician network and Accountable Care Organization (ACO) sponsored by Dignity Health and Abrazo Health.  The Network Development Associate is an employee of Dignity Health Management Services Organization.  Under the direction of the ACN Provider Network Development Manager, this individual assists with the development and maintenance of the provider network to ensure adequacy of the network for the highest quality, cost-effective providers of healthcare services and a successful physician integration strategy.

     

    The Network Development Associate locally supports the ACO/CI program through ongoing interaction with potential and participating physicians and ACN leadership. 

     

     

    PRINCIPLE DUTIES AND RESPONSIBILITIES

     

    KEY RESPONSIBILITIES & ACCOUNTABILITIES:

    • Collaborates with ACN leadership to strategize provider recruitment activities.
    • Under direction from the Provider Network Development Manager, provides local support activities to address adequacy needs in the ACN participating provider network by maintaining targeted recruitment list and pipeline, and securing meetings with targeted physicians/provider groups to gain their participation in the network.
    • Identifies synergy between ACN and potential new providers, and develops and maintains positive, mutually successful relationships with potential network providers and their key administrators; rounds on potential new providers to develop and maintain relationship-building, including local travel.
    • Provides feedback in the form of progress reports to Director of Provider and Member Relations of current contract negotiations, meetings and pipeline.
    • Processes provider applications for participation in the network, ensuring that all required information, supporting documentation and signed agreements are in place for ACN Network Development Committee review, and ensures relevant data for approved providers is entered in to the Physician Relationship Management Tool SalesForce.com.
    • Contributes to the preparation of monthly Network Development Committee meeting agendas, and presents applicants for Committee review.
    • Submits necessary documentation to CMS for approval of provider/group as a Participant in the Medicare Shared Savings Program ACO; monitors CMS application review process and performs resubmissions as required.
    • Performs monthly non-par provider reconciliation with contracted CI payers to facilitate alignment of ACN provider network with contracted CI provider networks.
    • Assists with the ongoing maintenance of ACN network including provider communications and in person visits as set forth by ACN.
    • Other duties as assigned.

    Qualifications

    POSITION QUALIFICATIONS

     

    1. A) EXPERIENCE: Minimum 3 years experience in provider relations, provider credentialing, provider contracting and/or network development in a health care or managed care setting required.
    2. B) EDUCATION AND TRAINING: College degree preferred, high school diploma or equivalent required.
    3. C) LICENSE, CERTIFICATION AND REGISTRATION: None
    4. D) SPECIALIZED KNOWLEDGE AND SKILLS: Demonstrated skills in the areas of written and verbal communication, judgment, problem-solving, presentation and public relations. 
    5. E) OTHER REQUIREMENTS: This position requires a highly motivated person with exceptional customer service, relationship management and interpersonal skills. Attention to detail. Capable of independent thinking, as well as perform in a team environment. Position will require automobile travel. 

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