Provider Relations Specialist - Queens Territory
HealthCare Partners, MSO
Garden City, NY
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JOB DETAILS
SALARY
$65,000–$75,000 Per Year
SKILLS
Administrative Skills, Business Administration, Claims Processing, Consulting, Cross-Functional, Data Analysis, Documentation, Health Maintenance Organization (HMO), Health Plan, Healthcare, Healthcare Administration, Healthcare Effectiveness Data and Information Set (HEDIS), Healthcare Providers, Industry/Trade Analysis, Managed Care, Medicaid, Medicare, Performance Management, Performance Metrics, Performance Tuning/Optimization, Primary Care, Process Improvement, Provider Relations, Quality of Care, Regulations, Regulatory Compliance, Risk, Sales Management, Service Delivery, Standards of Care, Strategic Planning, Team Player
LOCATION
Garden City, NY
POSTED
11 days ago
HCP’s vision is to be recognized by members, providers and payers as the organization that delivers unsurpassed excellence in healthcare to the people of New York and their communities. We pride ourselves on selecting the most qualified candidates who reflect HCP’s mission of serving our members by facilitating the delivery of quality care. Interested in joining our successful Garden City Team? We are currently seeking a Provider Relations Specialist for our Queens territory!
Position Summary: The Provider Relations Specialist is the mission-critical linchpin between HealthCare Partners and our network of primary care physicians. This role focuses on fostering strong working relationships with PCPs and staff in an ongoing effort to advance HCP’s organizational objectives, facilitate value based care, and improve both provider satisfaction and member health. The Provider Relations Specialist leverages data and knowledge of the primary care setting to identify PCP opportunities and tailor strategic action plans to support success. The Provider Relations Specialist serves as an internal subject matter expert with regard to their territory and collaborates cross departmentally to engage physicians optimally. This unique role blends a service and consultative approach to ensure HCP achieves its mission.
Essential Position Functions/Responsibilities:
- Establish and maintain collaborative relationships with PCPs and their staff through regular touchpoints, acting as the primary liaison between HCP and the provider network.
- Educate providers on HCP’s value-based care model, ensuring alignment with organizational goals and objectives.
- Spend approximately 90% of scheduled work time conducting face-to-face provider office visits.
- Provider Relations Specialists are expected to spend approximately 4.5 days each week in the field, with approximately 0.5day reserved for administrative responsibilities, including scheduling, documentation, reporting, and internal meetings, based on business needs.
- Proactively identify and address provider concerns, leveraging data and analytics to tailor strategic action plans.
- Serve as a point of contact on provider relations, offering guidance to internal teams and stakeholders.
- Provide strategic insights and recommendations to providers on optimizing performance in key metrics such as HEDIS, HCC, and STAR ratings.
- Collaborate with cross-functional teams—including Quality, Risk Adjustment, and Care Management—to drive performance improvement and ensure seamless provider support.
- Continuously evaluate processes and recommend improvements to enhance provider relations and streamline operational workflows.
- Maintain up-to-date knowledge of industry regulations, trends, and payer policies to provide informed guidance to providers.
Qualification Requirements:
Skills, Knowledge, Abilities
- Establish and maintain collaborative relationships with PCPs and their staff through regular touchpoints, acting as the primary liaison between HCP and the provider network.
- Educate providers on HCP’s value-based care model, ensuring alignment with organizational goals and objectives.
- Spend approximately 90% of scheduled work time conducting face-to-face provider office visits.
- Provider Relations Specialists are expected to spend approximately 4.5 days each week in the field, with approximately 0.5day reserved for administrative responsibilities, including scheduling, documentation, reporting, and internal meetings, based on business needs.
- Proactively identify and address provider concerns, leveraging data and analytics to tailor strategic action plans.
- Serve as a point of contact on provider relations, offering guidance to internal teams and stakeholders.
- Provide strategic insights and recommendations to providers on optimizing performance in key metrics such as HEDIS, HCC, and STAR ratings.
- Collaborate with cross-functional teams—including Quality, Risk Adjustment, and Care Management—to drive performance improvement and ensure seamless provider support.
- Continuously evaluate processes and recommend improvements to enhance provider relations and streamline operational workflows.
- Maintain up-to-date knowledge of industry regulations, trends, and payer policies to provide informed guidance to providers.
Training/Education:
- Bachelor’s degree in healthcare, business administration or equivalent working field experience, required.
- Non-Bachelor’s degree in clinical discipline considered.
Experience:
- Two or more years’ experience in HMO, IPA or medical group, Physician Management Company, or other managed care organization.
- Consulting or Account Management experience considered.
Our website: HealthCare Partners
Base Compensation: $65,000 - $75,000 annually
Bonus Incentive: Up to 12.5% annually based on organizational performance
Benefits: Fully paid Medical & Dental employee coverage + robust benefits package (PTO, 401k, FSA, Tuition Reimbursement, etc.)
HealthCare Partners, MSO is committed to fostering a diverse and inclusive workplace. We provide equal employment opportunities (EEO) to all employees and applicants without regard to race, color, religion, sex, national origin, age, disability, genetics, or any other protected status under federal, state, or local laws. In compliance with all applicable laws, HealthCare Partners, MSO upholds a strict non-discrimination policy in every location where we operate. This policy applies to all aspects of employment, including but not limited to recruitment, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
Job Disclaimer:
The above job description outlines the general scope and responsibilities of the position. It is not intended to be an exhaustive list of duties, skills, or qualifications required. Responsibilities may evolve based on business needs.
About the Company
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