Corporate Provider Network Management Communication Consultant (Managed Care or Healthcare required)

Amerihealth
Published
October 8, 2020
Location
Philadelphia, PA
Category
Job Type

Description

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.

Responsibilities:

Under the direction of the Director, Corporate Provider Communications, the Corporate Provider Communications Consultant is responsible to consult with and support the local Plan Provider Communications Specialist to create informative, up-to-date provider education and training resources and programs that increase the effectiveness of providers’ compliance and interaction with the Plan.  Participates in enterprise project planning and develops provider communication materials to support implementation of enterprise provider initiatives; consults and coordinates with local plan staff to roll-out provider communication campaigns and to promote the adoption of best practices to ensure consistent messaging across plans. Works on new market entry projects to develop and deliver provider recruitment collateral in support of network building activities; creates provider content for new business implementations and transitions provider communication functions to local staff as part of new business implementation process. The incumbent is responsible for supporting communication tasks that impact external customers from the provider perspective, including written and online communications to physicians, hospitals, and ancillary providers for new and existing Medicaid plans, and existing Medicare plans. Assesses impact of enterprise initiatives, annual goals, or regulatory changes on providers; engages with enterprise work groups to develop strategies and applicable materials for health plans to inform and educate their networks.

Principal Accountabilities:

  • Leads provider communication strategies for enterprise initiatives and develops supporting collateral (web site content, template notices, provider premiums,) for health plans to use to achieve desired results.
  • Develops provider materials for provider recruitment and onboarding activities related to new business, such as new provider manuals, materials, and provider forms, with New Business Leader’s approval consistent with enterprise processes. [RK1] 
  • Acts as liaison between Plans and corporate partners for provider material development.
  • Supports and trains local Plan Provider Communications Consultants to ensure plan goals and provider network management strategies are successfully communicated to provider network.
  • Collaborates, as needed, on development of Provider Network Management policies and procedures in conjunction with Corporate Provider Network Management Communications Director to meet new Medicaid business requirements.
  • Partners closely with local health plan provider communications specialists to understand existing Medicaid provider requirements to help local provider communications specialist maintain accurate provider education and training materials and web resources.
  • Serves as subject matter expert for CPNM Training team in developing provider education materials for new markets that meet the overall strategy and priorities of the AmeriHealth Caritas Family of Companies AOP goals and State requirements.
  • Acts as a supporting partner to the Corporate Provider Communications Trainer to develop education programs for the Provider Network Management staff, as well as Plan contracted providers regarding Medicaid requirements and health plan policies.
  • Assists Corporate Provider Communications trainer with content and strategies to train local provider account executives who will engage contracted providers’ office managers/staff in training sessions held throughout the service area for Medicare and new Medicaid programs. Assists Corporate Provider Network Management Directors and Corporate Provider Network Management Communications Director with identifying trends to improve provider satisfaction and compliance with Plan operations, payment policies, prior authorization requirements, etc.
  • Collaborates with care management and quality teams regarding enterprise implementation of products and communications related to improved health status of our members, achieving NCQA accreditation, HEDIS measures, etc.
  • Maintains positive relationships with the provider community, both contracted and non-contracted providers as required.

Education/ Experience:

  • Bachelor’s Degree from an accredited college (i.e. Communications, Marketing or  similar academic discipline preferred).
  • Minimum of 5 years of experience demonstrating  strong written communication and presentation skills along with training material development.
  • Minimum of 3 years of experience in Provider Relations or Provider Operations in a Healthcare or Managed Care Organization.
  • Required 1 year Project Management experience.
  • Valid Driver’s License & current auto Insurance  and willingness to travel up to 25%.
  • Proven ability to building long term relationships and and  to work in a matrixed environment.
  • Demonstrating strong analytical skills to turn data into a narrative.  Conduct focused examination of conditions requiring correction and develop a precise definition of the problem.
  • Expert in MS. Word and proficient Adobe Acrobat.
  • Preferred experience with Marketing and digital communication platforms..

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