Provider Services Coordinator
Genesee County
WHAT IT IS…
General Description
The Provider Services Coordinator serves as the primary liaison between Families and Children Together (FACT) and the network of local behavioral health, physical health, and specialty care providers. The Provider Services Coordinator’s primary responsibilities include providing training, education, and guidance to cultivate robust partnerships with FACT’s provider associates through face-to-face or virtual meetings and resolving outstanding claims with the provider network. This role is also responsible for promoting the provider network by identifying, engaging, negotiating with, and contracting with other specialty providers. The Provider Services Coordinator will uphold organizational integrity through conducting analyses of provider data and securing resolutions to outstanding claims. In all interactions, the Provider Services Coordinator will demonstrate a strong professional image and positive disposition of FACT.
YOU WILL GET TO…
Provider Network Management:
Routinely engages with local providers to grow and expand provider relationships,
Serves as the primary point of contact for all issues and claims related to the provider network.
Investigate and address provider-related complaints, claims reported as incorrect, payment discrepancies, and similar provider-related issues and conduct root cause analysis for mitigation and resolution.
Develops provider education and training to clarify for providers to understand federal, state, and FACT policies and systems.
Promotes provider adherence and compliance with their respective contracts and manuals to include periodic and annual audits and reviews.
Distributes necessary information and materials to network providers through mail/email, phone calls, virtual meetings, or in-person visits as needed.
Interacts with providers on (at minimum) a monthly basis and conducts quarterly business reviews with network providers.
Network Sufficiency:
Conducts research within the community and contacts eligible providers through phone, email, or site visits to target gaps insufficiency, and areas of improvement or opportunity
Oversees all providers within the region of operation and maintains network adequacy.
Recruits, negotiates, and contracts with providers effectively.
Gathers provider credentials and submits files and reports to the quality department annually and ensures providers maintain licenses in good standing.
Retains all relevant reports and assists with annual accreditation cycles.
Conducts regular analysis of policies and contracts with providers for quality improvement.
WHAT WE ARE LOOKING FOR…
Possession of a bachelor’s degree in healthcare administration, social work, or related field
Experience in provider network management or community relationships is strongly preferred
Excellent written and verbal communication/presentation skills
Excellent organizational and interpersonal skills
Prior program/administrative support experience preferred
Prior experience with Microsoft Office and related applications
Prior experience using standard office equipment
Able to work a flexible schedule, with “regular” business hours set by the Agency
Satisfaction of all employment eligibility and Agency hiring requirements
OTHER STUFF…
Genesee
County
POSITION AVAILABLE
Apply on Indeed.com
Reporting Relationships:
Reports to the CEO
Position Type:
Full-time, with occasional evening and weekend hours required for community events and client appointments.
Location:
The position will be based at FACT's Service Hub with frequent travel within the community to meet with clients and attend events.