Provider Relations Specialist

Job Title:

Provider Relations Specialist Department:

Provider Relations Reports To:

Director of Operations Location:

Westminster Orange County CA Company:

Family Choice Management Services (FCMS)

About Us:

Family Choice MSO's mission is to provide comprehensive, efficient, and high-quality management and administrative support to medical practices. By handling the non-clinical aspects of medical operations, the MSO enables healthcare providers to focus on delivering exceptional patient care. The MSO is dedicated to fostering the growth and sustainability of medical practices by offering expert services in administration, finance, human resources, compliance, and technology.

Job Type:

Full-Time Job Summary The Provider Relations Specialist is a key liaison between the Independent Medical Practice Association (IPA) and its network providers. This role ensures effective communication, fosters strong relationships, and addresses the needs and concerns of providers to maintain high levels of satisfaction and compliance. The Specialist also works to educate providers on IPA policies, procedures, and updates, while supporting the delivery of quality healthcare services. Key Responsibilities Provider Relationship Management Serve as the primary contact for contracted providers, addressing inquiries and resolving issues promptly. Build and maintain positive relationships with healthcare providers and their office staff. Conduct regular site visits to providers to ensure satisfaction and alignment with IPA objectives. Education and Communication Provide training and education to providers on IPA policies, procedures, and compliance requirements. Disseminate updates related to health plan changes, contract amendments, and regulatory requirements. Facilitate meetings and webinars to communicate IPA initiatives and operational updates. Contract and Compliance Support Assist with the onboarding process for new providers, including credentialing and contract execution. Monitor provider adherence to IPA contracts, payer agreements, and regulatory standards. Collaborate with internal departments to ensure provider compliance with quality and performance metrics. Problem Resolution Act as a resource for resolving operational and administrative issues between providers and payers. Escalate complex issues to the appropriate departments and follow through to resolution. Document and track all provider concerns, ensuring timely resolution and feedback. Performance Monitoring Analyze provider performance data to identify trends and areas for improvement. Collaborate with providers to develop action plans for meeting quality and cost-effectiveness goals. Provide input on strategic initiatives to improve provider engagement and network performance. Qualifications Education and Experience Bachelor's degree in healthcare administration, business, or a related field; or equivalent experience. Minimum of 3 years of experience in provider relations, network management, or healthcare operations, preferably in an IPA or managed care setting. Strong knowledge of healthcare delivery systems, managed care, and payer-provider contracts. Knowledge of state and federal healthcare regulations, including CalOptima, HIPAA and CMS guidelines.

Skills:

o Bilingual (English and Vietnamese) or (English and Spanish) o

Communication:

Strong verbal and written communication skills, with the ability to explain complex information clearly and concisely to patients and providers. o

Empathy and Patience:

Ability to handle sensitive situations with empathy and patience, particularly when dealing with vulnerable populations such as Medicaid and Medicare patients. o

Problem-Solving:

Effective problem-solving skills, with the ability to think critically and resolve issues efficiently. o

Technical Proficiency:

Comfortable using customer service software, EHR systems, and Microsoft Office Suite (Word, Excel, Outlook). o Attention to

Detail:

Strong attention to detail, ensuring accuracy in all documentation and communications. o

Multitasking:

Ability to manage multiple tasks simultaneously while maintaining a high level of service.

Personal Attributes:

o

Compassionate:

A genuine desire to help others and improve patient experiences. o

Team-Oriented:

Works well in a team environment, collaborating with colleagues to achieve common goals. o

Reliable:

Dependable and punctual, with a strong work ethic. o

Adaptable:

Able to adjust to changes in processes, regulations, and patient needs.

Working Conditions:

Environment:

The role is primarily office-based and may involve traveling to providers' offices.

Hours:

Regular business hours, with occasional evening or weekend shifts to accommodate patient needs.

Benefits:

Competitive salary and benefits package, including health insurance, paid time off, 401(k), and opportunities for professional development. How to

Apply:

Please submit your resume and cover letter outlining your qualifications and interest in the position by calling 714-898-0765 or emailing: tdang@familychoice.com . We look forward to reviewing your application and considering you for this exciting opportunity to make a difference in patient care within our

Management Service Organization Job Type:

Full-time Pay:

$25.96 - $32.69 per hour

Benefits:

401(k) Health insurance Paid time off

Work Location:

In person