PACE Provider Support Specialist

Provider Relations

Under the direct supervision of the PACE Network Manager, the Provider Relations will serve as the business liaison between San Diego PACE and potential contracted and contracted providers. The major functions of the Provider Relations will be to take a focused approach when conducting outreach and target areas identified as requiring development and ensuring to foster a strong and collaborative relationship with contracted provider network. The Provider Relations is also responsible for securing all required documentation in a timely manner and will scheduling meetings with the appropriate PACE departments to conduct introductions and provide all newly contracted provider a warm hand-off upon contract execution.

Essential Functions of the Job :

• Assist in identifying network deficiency and focus on growing the San Diego PACE network in these identified areas.
• Meet with providers to discuss the possibility of becoming a contracted provider.
• Responsible for securing all required documentation to ensure compliance.
• Conduct outreach, San Diego PACE presentations, facilitate onboarding and schedule trainings with providers.
• Conduct contractor assessments, ensure providers follow CMS guidelines, document findings, and generate reports.
• Bring to the attention of the Network Provider Administrator and Network Manager any trends or matters that may negatively impact our ability to maintain an agreement.
• Maintain a contract progress report and track all efforts weekly.
• Schedule conference calls with Providers and Network Manager to discuss services and reimbursement rates.
• Conduct site visits and ensure provider office location is appropriate and accessible to PACE participants.
• Review existing client contracts to accurately prepare new contract requests and / or respond to internal or external contract questions
• Ability to build and maintain positive relationships
• Ability to work independently as well as work effectively in a group.

Additional Duties and Responsibilities :

Job Requirements :

Education Requirements :

Experience Requirements :

Universal Requirements :

Pre-employment requirements include I-9, physical, positive background and reference check results, complete application, new hire orientation, pre-employment PPDs