p>Manage projects: • Provides status of projects as well as ensures completion of projects assigned • Provides coaching/mentoring for staff • Identifies improvement for further training/education • Critical thinking that solves problems with a logical, analytical discipline with a view on how decisions may impact provider/practice operations • Understanding of various reimbursement methodologies as it relates to the community provider network • Strong grounding of core principles and the role of hospitals within both Clinical Efficiency, Population Health, and Administrative Efficiency • Proactively identify trends of issues, root causes and their magnitude, develop and implement action plans to closure • Ability to review and draw conclusions from reports that integrate job knowledge and practical applications that answer or respond to a question or issue or may lead to other issues • Fiscal understanding of reimbursement and utilization practices • Ability to analyze reports related to provider performance and relate provider practice patterns to overall trends • Negotiation skills which clearly allow for ranges of discussions with a clear line of escalation when necessary as well as presentation for approval from Senior Management • Regulatory/ Legal understanding of the contracting logistics • Solid understanding of terms of contracts and how they should be applied: financial, amendment, termination, etc.
Promote successful internal collaboration within Healthfirst for our providers:
• Shared mutual goals by working directly with the hospital and affiliated provider teams to improve their clinical, quality and member satisfaction outcomes • Provide effective education and communication of Healthfirst benefits and policies, changes, and effects to individual practices • Collaborate, develop, and deliver appropriate reports that allow provider partners to better manage their patient population (roster, care plans, quality reports, etc.) • Propose and implement initiatives or process changes with providers that will ultimately encourage process improvements within the healthcare delivery/administrative structure • Provide customer service focused leadership to optimize provider satisfaction through timely and accurate issue resolution • Propose and implement initiatives or process changes with providers that will ultimately encourage process improvements within the healthcare delivery/administrative structure.