Hours:
Shift Start Time:
8 AMShift End Time:
5 PMAWS Hours Requirement:
8/40 - 8 Hour ShiftAdditional Shift Information:
Weekend Requirements:
As NeededOn-Call Required:
NoHourly Pay Range (Minimum - Midpoint - Maximum):
$33.090 - $42.700 - $52.310The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.  The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.
What You Will Do
Professionally manages all aspects of an assigned SCMG provider region. Works closely with the physician network, affiliated hospitals, ancillary providers, Sharp HealthCare and all departments within SCMG. Specifically, recruit, orient and provide ongoing service to providers and ensure provider adherence to policies and procedures of SCMG and affiliated health plans. Identifies and resolves providers issues or concerns in a timely manner. Consistently supports SCMG by maintaining a positive and professional image.
Required Qualifications
Essential Functions
Responsible for maintaining and enhancing relationships with Providers (including ancillary) and office staff.Assist with development of marketing and public relations materials as requested for SCMG and its providers, affiliated health plans, hospitals, or consulting groups, such as newsletters or photographs of physiciansBusiness development
Develop relationships with community businesses (i.e. Senior Centers, Assisted Living Homes, Marketing Consulting Groups, etc) and coordinate lectures, screenings, and other marketing events with that businessCollaboration and teamwork
Oversees activities and coordinates projects with other persons within the Network Management Department to provide education and communicate information to the provider network. (i.e. Regional Council Meetings, PCP council, Office Manager Meetings, Joint Operation Committee Meetings, etc.).Community outreach activities
Participate in health fairs, lectures, community events, and other marketing events to promote IPA and it's affiliated providers.Data collection and distribution
Responsible for producing, updating, and distributing information to provider network, including patient satisfaction reports, Pay for Performance initiatives and QISR.General support
Perform other functions as requested.Health education
Coordinate and provide assistance to health plans and other clients as necessary for health education services (i.e. participate in health fairs and member orientations as needed).Information systems support
Supports physicians and staff when implementing Information Technology in the provider offices. Able to demonstrate knowledge of hardware specifications and software applications. Installs, trains and maintains necessary applications in provider offices. Acts as liaison between Sharp IS and provider office.Meeting participation
Attend meetings as needed to provide information about IPA's policies & procedures and operations or as a departmental representative. Responsible for agenda preparation and content; records meeting minutes.Physician contracts
Ability to review, negotiate and comprehend physician contracts in order to respond to inquires from physicians & staff. Conducts contract analysis related to contract performance by examining appropriate claims and other applicable data.Problem resolution
Act as a liaison to ensure timely problem/issue resolution between Health Plans, Hospitals, SCMG, and Providers. Accountable as a liaison between providers and SCMG departments for successful identification and resolution of issues.Professional development
Identify and participate in educational classes that will improve the relationship between SCMG and physician network.Reports and surveys
Coordinate the production and dissemination of necessary reports and surveys to effectively manage assigned region.Training and education
Responsible for conducting on and off-site training sessions for new and existing Providers and office staff. This includes but is not limited to education regarding contract interpretation, claims, coding, operations, reimbursement, compliance issues, clinical operations, policy and procedures, governmental regulation and technology solutions, i.e., HIPPA, AB1455 and Pay for Performance.
Knowledge, Skills, and Abilities
Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class
Associate's Degree