Provider Relations Advocate, Full Time - Days
UChicago Medicine · United States
Be a part of a world-class academic healthcare system, UChicago Medicine, as a Provider Relations Advocate. This is a Hybrid remote opportunity, and you will need to be based inside of the greater Chicagoland area.
Responsible for developing and maintaining relationships with UCM hospitals and physicians to support all aspects of the UCM managed care contractual relationships including provider services, provider contract education and communication, provider reimbursement, payer relations and contract compliance. Manage operational and administrative relationships with third party payers and assists in coordinating and facilitating joint operating committee and payer operations meetings to resolve issues. Ensure the delivery of provider services including payer contract updates, payer policy changes, reporting and process improvement for managed care operations. Partner with OMC team members to ensure successful contract implementation, monitoring and enforcement of contract terms and support for value base care contracting initiatives. Support ongoing education to providers and their revenue cycle staff regarding third party payer contract terms, value based care arrangements and insurance market changes.
Essential Functions
- Build and maintain provider and third party payer relationships that deliver operational support and efficiencies, ensure compliant administration of contracts, and education and training that results in overall provider and payer satisfaction.
- Maintain regularly scheduled meetings and develop and present educational materials for UCM hospitals and physicians regarding third party payer contract terms, value based care requirements and performance, operational processes and payer/insurance policy and market changes.
- Serve as primary liaison between UCM hospitals and physicians and third party Commercial, Value Based, Medicare Advantage, and Managed Medicaid payers to provide support in resolution of operational and payer compliance issues.
- Manage and facilitate monthly payer joint operating committee meetings and payer operational meetings including scheduling, agendas, meeting minutes and follow-up on action items from the meetings in collaboration with hospital and physician revenue cycle staff with the goal to identify and escalate high level issues for remediation and root cause analysis, as well as, stay informed of payer updates.
- Support Director of Provider and Payer Relations in facilitation of key OMC meetings including Technical Workgroup and OMC Revenue Cycle/UCPG Revenue Cycle, as well as, participates and coordinates periodic meetings with internal UCM key internal stakeholders to share critical information regarding managed care contract updates and market trends.
- Collaborating with the Technical Workgroup, provide the Contracting team with feedback on issues to be addressed in contract negotiations; include policy, operational and claims concerns and data/analysis to strengthen our negotiating position.
Required Qualifications
- Bachelor’s Degree required (in lieu of a Bachelor’s Degree, work experience may be considered)
- Five (5) years managed care health care experience required to include provider relations and claims or network management experience in provider or third party payer setting
- Experience in a multi-facility health system, large academic medical center, or insurer environment highly desirable.
- Direct experience working between providers and third party payers to facilitate issue resolution.
- Strong knowledge base of hospital and physician revenue cycle operations required
- Experience and knowledge of value based care initiatives including risk contracts and population health management highly desirable.
- Specific thorough understanding of physician and hospital coding, claim forms and payer EOBs
Skills
- Ability to maintain strong connections to internal providers and external payers through relationship management and exceptional customer service mentality
- Self –starter and ability to take initiative and ownership of work
- Strong written and verbal communication skills
- Strong presentation skills
- Adapts well to rapid change and multiple, demanding priorities with excellent time and project management skills.
- Strong attention to detail and well organized
- Ability to multitask, problem solve, facilitate and collaborate on various work streams and projects. Ability to facilitate discussion and resolution
- Ability to work across a broad network of operational teams and provider locations
- Advanced working knowledge of Microsoft Office Suite, particularly Word, MS Excel and PowerPoint
Position Details:
- Job Type/FTE: Full Time (1.0 FTE)
- Shift: Days, Monday-Friday
- Unit/Department: Managed Care- Hyde Park
- Work Location: Hybrid Remote (will need to commit to coming onsite to Hyde Park and Burr Ridge as needed)
- CBA Code: Non-Union
We’ve been at the forefront of medicine since 1899. We provide superior healthcare with compassion, always mindful that each patient is a person, an individual. To accomplish this, we need employees with passion, talent and commitment… with patients and with each other. We’re in this together: working to advance medical innovation, serve the health needs of the community, and move our collective knowledge forward. If you’d like to add enriching human life to your profile, UChicago Medicine is for you. Here at the forefront, we’re doing work that really matters. Join us. Bring your passion.
UChicago Medicine is growing; discover how you can be a part of this pursuit of excellence at: UChicago Medicine Career Opportunities
UChicago Medicine is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status and other legally protected characteristics.
As a condition of employment, all employees are required to complete a pre-employment physical, background check, drug screening, and comply with the flu vaccination requirements prior to hire. Medical and religious exemptions will be considered for flu vaccination consistent with applicable law.
Compensation & Benefits Overview
UChicago Medicine is committed to transparency in compensation and benefits. The pay range provided reflects the anticipated wage or salary reasonably expected to be offered for the position.
The pay range is based on a full-time equivalent (1.0 FTE) and is reflective of current market data, reviewed on an annual basis. Compensation offered at the time of hire will vary based on candidate qualifications and experience and organizational considerations, such as internal equity. Pay ranges for employees subject to Collective Bargaining Agreements are negotiated by the medical center and their respective union.
Review the full complement of benefit options for eligible roles at Benefits - UChicago Medicine.
University of Chicago Medical Center | Managed Care | Full Time (40 hrs per week) | Day Shift