Practice Management Consultant

Practice Management Consultant
Massillon, OH
Full-Time
Provider Delivery Services
Manager

The Practice Management Consultant provides education, training and guidance for providers in the assigned provider network; drives quality discussions to increase member care, member satisfaction and provider satisfaction, responsible for performing on-site reviews of new and re-credentialed providers within their assigned territory; identify and educate providers requiring additional education (performed on-site, via conference call and/or via webinar)

  1. College degree or 3-4 years’ experience in a physician’s office, payer agency, community agency or other health care environment;
  2. Valid driver’s license;
  3. Previous customer service experience with exposure to claims and benefits interpretation and provider networking;
  4. Knowledge of medical coding;
  5. Knowledge of HEDIS® and Star Ratings;
  6. Computer experience with Microsoft Word, Excel, Power Point and Outlook.

  1. Strong verbal and written communication skills with the ability to communicate (oral and written) effectively;
  2. Strong project management skills;
  3. Must be able to perform presentations for small and large audiences in person and remotely;
  4. Organizational skills with the ability to handle multiple tasks and/or projects at one time;
  5. Customer service skills with the ability to interact professionally and effectively with providers, and staff;
  6. Time management skills with the ability to prioritize and schedule daily activities for the most efficient use of time;
  7. Problem resolution skills;
  8. Ability to work under little supervision and act as a team member;
  9. Familiar with current managed care, State and/or Federal healthcare programs (Medicare, Medicaid) and the insurance industry;
  10. Experience in managed care, State and/or Federal health programs;
  11. Certified Medical Insurance Specialist;
  12. Ability to work with value based reimbursement/initiatives/projects;
  13. Certification or equivalent experience in human resource management.

Employment Documents

EEO

Or, if you are interested in a fast-paced career with us, please send resume with salary requirements to:

HR Department 
1110 Main Street
Wheeling, WV 26003-2704
hr@healthplan.org