Representative, Professional Relations & Risk Initiatives - Rochester
MVP Health Care - Rochester, NY

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Under the direction of the Manager, Professional Relations:
The Professional Relations Representative supports the Professional Relations Plan in maintaining positive, cooperative relationships with physicians, other health professionals, and their office staffs and increasing their overall level of satisfaction with MVP Health Care. Orients health professional office staff on policies and procedures. Identifies, tracks and trends issues identified by employees, health professionals and their office staff, and drive changes needed for resolution. Support Shared Risk Initiatives as the liaison to physicians and their staff on risk reporting that includes payment reform, quality metrics, efficiencies and delivery of practice score cards. Provides ideas and material to Communications Department for developing and communicating information to health professionals and office staff. Performs other duties as assigned. POSITION QUALIFICATIONS. Minimum Education: BA degree preferred in Business Administration or related field. Minimum Experience: Three years customer service experience in a managed care or medical office practice setting. Experience interacting with providers required. Required Skills: Familiarity with office practice procedures, pre authorization and referral issues, fee policy and billing processes, the provider grievance and appeal process, physician performance reporting.Excellent communication and interpersonal skills, including the ability to negotiate, interact face-to-face and over the telephone with customers. Demonstrated strong presentation and facilitation skills. Ability to effectively handle difficult interpersonal situations. Demonstrated strong written skills, including the ability to create letters and other communications to providers. Valid NYS driver s license and access to a vehicle. Analytic skills. Proficiency with Word, Excel and PowerPoint (or comparable software). Proficiency with Facets and Macess. Proficiency with AMISYS and Service Matrix required within six months from date of hire. Understanding of the following reimbursement models: RBRVS fee schedule. Neat, well-groomed, professional appearance with positive, enthusiastic attitude. Able to demonstrate strong relationship building skills.

Requirements:

MVP Health Care - 12 months ago - save job - block
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About this company
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MVP Health Plan covers about 650,000 most valuable people. Also known as MVP Health Care, the company provides health insurance and employee...