Field-based Provider Relations Rep- Medicare Adv Plan/ACO

Physician Relations Representative (Provider Relations Specialist)

Family Medicine / Internal Medicine Offices

Full time - Monday- Friday

Field Based Rep - 3 travel days within the territory and 2 days in remote office

Miami- Dade County 33165 and surrounding areas

Must have at least 2 years of experience with with providers in managing the value based care reports to improve CMS savings

The Physician Relations Representative is responsible for fostering a strong and satisfied network of healthcare providers in a designated area.

They serve as the main liaison between practices, the company, and health plan partners. Their main focus is to work closely with providers to improve performance in areas like cost reduction, revenue optimization, quality enhancement, and provider satisfaction for Medicare patients.

Requirements

• 2+ years in Provider Relations, Network Management (field based or office based exp) in an ACO. MSO or Medicare Adv Plan
• Experience in provider education, performance review, improvement plans and account management
• Experience discussing these reports with the provider such as HEDIS, CMS Star Rating System, and most importantly the (MLR )Medicare Loss Ratio, (MRA) Medicare Risk Adjustment, and (RAF) Risk Adjustment Factor.
• Bachelor's degree a plus, not required
• Valid driver's license and reliable transportation required
• Ability to travel - 3 days in the field / 2 admin days remote (Full-time M- F)
• Strong interpersonal and communication skills
• Experience in presentations
• Analytical and problem-solving skills
• Time management and organizational skills
• Attention to detail and reliability
• Proficiency in MS Office programs and Excel
• Bilingual in Spanish and English, for Miami territory

Key Responsibilities :

• Provider Education and Support : Provide comprehensive education and tools to help providers meet quality and financial goals.
• Accountability and Performance : Understand and improve the financial performance of practices, ensuring they meet key performance indicators.
• Provider Training and Orientation : Conduct orientation sessions and ongoing training for providers and their staff.
• Provider Retentio n : Work to retain providers by ensuring their satisfaction with the organization.
• Provider Collaboration : Facilitate meetings to enhance patient outcomes and operational efficiencies.
• Performance Improvement Plans : Develop, implement, and monitor improvement plans for provider groups.
• Provider Negotiations : Negotiate contract terms and analyze proposals.
• Communication and Issue Resolution : Maintain open communication channels and resolve issues promptly.
• Strategic Planning : Collaborate to implement strategic interventions.
• Onsite Provider Visits : Spend most of the workweek visiting providers, with clear objectives for each visit.
• Engagement with Specialists : Focus on engaging high-quality specialists and improving coordination of care.

Compensation :

Base salary $70k-$80K ( possible bonus) plus expense reimbursement, car allowance, 18 days PTO, fully subsidized health benefits, Holidays, 401k

Please submit your resume in a word document. If you are a match, a ttg Talent Solutions recruiter will contact you by phone, email or text. Please monitor your inbox.

At ttg, We believe in making a difference One Person at a Time ttg OPT.