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Provider & Community Relations Coordinator (Greene county, PA)

  • Job ID: 203340743
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: Community Care Behavioral Health
  • Department: Network Mgt-Sat NC-DUB
  • Location: 235 Beaver Drive, Dubois PA 15801
  • Union Position: No
  • Salary Range: $19.41 to $32.25 / hour

Description

At UPMC, we’re all here for the same reason – to make Life Changing Medicine happen. Join our team and you will play a unique and important role in our mission to change healthcare for the better.

Are you looking to be a part of community and provider outreach, education and prevention efforts?  Do you have a Bachelors’ degree in a social service related field? Do you have at least two years’ experience in a health care or managed care environment?  If so, UPMC may have the perfect employment fit for you! 

UPMC is hiring a full-time Provider & Community Relations Coordinator to support our Network Management department within the Community Care Behavioral Health business unit. This will primarily be a Monday through Friday daylight role that will also require some evening and weekend hours. This is a hybrid role, with some work-from-home/remote work and some travel within the community. The position will cover the Greene County and surrounding areas. The Provider & Community Relations Coordinator will be travelling locally,  as well as some occasional overnight travel throughout the state. The individual must be comfortable with travel to various, diverse locations.

The Provider & Community Relations Coordinator is responsible for developing and maintaining positive relationships with members, families, advocates, providers, and other interested stakeholders in the HealthChoices community. The Coordinator initiates and develops working relationships with external providers and manages a primary caseload of assigned providers for whom he/she is the principal point of contact. The Coordinator assures that the provider is fully educated as to appropriate policies and procedures for conducting business with Community Care. The Coordinator is also responsible for the implementation of Community Care's outreach, education, and prevention efforts to HealthChoices members, families, and stakeholders. The Coordinator develops outreach and education strategies and activities with the full intention of providing members and families with information and assistance that will eliminate and reduce barriers to behavioral health care services. These educational efforts support the company’s goal of making high-quality, cost -effective services readily available. The incumbent represents Community Care in venues concerned with community education, outreach, and prevention, and develops liaison efforts with its members, families, community stakeholders, and targeted populations.


Responsibilities:

  • Establish excellent working relationships with a defined panel of providers.
  • Understand and communicates the details of the authorization process and Community Care's procedures for delivering the authorizations to providers.Assure that assigned providers have current copies of all relevant educational materials, including the billing handbook and provider manual; is responsible for accurate interpretation of materials to providers in a consistent fashion and for identifying and proposing solutions to problems as they arise.
  • Participate in development and delivery of provider orientation and for follow-up as needed with assigned group. Develop and implement an Action Plan in response to each provider service call.
  • Work as member of the Provider Relations staff, ensure that corrective action plans are implemented and result in complete problem resolution.
  • Implement Community Care's outreach, education, and prevention efforts to HealthChoices members, families and stakeholders.
  • Develop outreach and education strategies and activities with the full intention of providing members and families with information and assistance that will eliminate and reduce barriers to behavioral healthcare services.
  • Record and archive the comments, suggestions and feedback from members, families and community stakeholders via Community Care?s advisory committees and other consumer/stakeholder feedback vehicles.
  • Use feedback and comments from these venues to assist in the development of Community Care?s outreach strategy and focus for its outreach plan and service plan development.

Qualifications

  • B.A .or B.S. degree in a healthcare, human services or related field.
  • 2 years of experience working in a complex organizational environment.
  • Experience as a provider of behavioral health services and/or knowledge of behavioral health provider system strongly preferred.
  • Excellent written and oral communication skills.
  • Must clearly and consistently articulate standards of care and specifics of the various provider agreements.
  • 2 years of experience in healthcare or managed care environment.
  • lndependent problem-solving skills, including the ability to address issues in a timely and accurate manner.
  • Knowledge of public and private delivery systems in behavioral health care.


Licensure, Certifications, and Clearances:



UPMC is an Equal Opportunity Employer/Disability/Veteran

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   Current UPMC employees must apply in HR Direct