Senior Regional Manager, Provider Relations - Community Health Choice
Harris Health System
Location: Houston, Texas
Type: Full Time
Internal Number: 156597
The Senior Regional Manager, Provider Relations is responsible for the day-to-day supervision and management of the Provider Relations staff, including, but not limited to; (1) maintenance of, and annual improvement in, Community's formal Provider Education Plan, (2) timely and efficient communication with participating providers, (3) timely and efficient resolution of provider inquiries and/or complaints, (4) collaboration with staff from Contracting and Credentialing and Data Integrity teams as it relates to maintenance of Community's provider network(s) from an Access/Availability and competitive standpoint, (5) identifying and implementing innovative means to improve provider engagement and overall performance, and (6) compliance with all local, state and federal laws and regulations, obligations set forth by TXHHSC and CMS, as well as any accreditation standards prescribed by NCQA and URAC.
BA/BS required. Four years' equivalent work experience may substitute for degree requirement.
Six years in the following areas: managed care with at least three years experience in Provider Relations/contracting with physicians, ancillaries, hospitals.
Two years experience in a management role.
Experience in STAR+PLUS a plus.
Must have medical contract negotiations experience, preferably in Houston market.
Writing /Composing, Correspondence/Reports
Must have car and valid Texas Driver's license.
Analytical, Medical Terms, Statistical, MS Word, MS Excel
The Harris Health System is a fully integrated healthcare system that cares for all residents of Harris County, Texas. We are the first accredited healthcare institution in Harris County to be designated by the National Committee for Quality Assurance as a Patient-Centered Medical Home, and are one of the largest systems in the country to achieve the quality standard. Our system includes 23 community health centers, five school-based clinics, a dental center and dialysis center, mobile health units, a rehabilitation and specialty hospital and two full-service hospitals.Ben Taub Hospital is a world renowned Level I Trauma Center with 586 licensed acute-care beds and provides a wide range of specialty care outpatient services. Lyndon B. Johnson Hospital is a 328 licensed bed acute-care hospital with a newly expanded Level III trauma center and a distinguished regional center for neonatal intensive care for high-risk deliveries.Harris Health is a teaching system for Baylor College of Medicine and The University of Texas Health Science Center at Houston (UTHealth). We train the next generation of healthcare providers on the latest medical procedures and technological breakthroughs.With... our fully integrated electronic medical records system, we offer patients the convenience and assurance that their medical history is accurate, safe and available when and where it is needed. Our Medical Home designation ensures that we offer a full range of preventive, specialty and acute care services for the entire family.