Job ID: J133356
Company: Gateway Health Plan
Location: Home, WV, United States
Facility: Work From Home
Full/Part Time: Full time
Job Type: Regular
Posted at: Dec 11, 2018
This job is the primary liaison between large/complex provider groups in the Organization network and the corporation. Will be responsible for cultivating relationships with large/complex provider groups to gain buy in and “sell” strategic initiatives for the purposes of piloting and implementing alternative care/reimbursement models. This job will maintain visibility in the provider community by representing the organization at various provider functions, meetings, and collaboratives. The incumbent will play an active role in network management, training, monitoring and enforcement of company policies and procedures while increasing provider efficiencies; participate as a regional representative on key operational/product/medical management/reimbursement projects/initiatives that impact providers (i.e. oncology pathways, tele-medicine, convenience care); recruit and introduce the Pay for Value (P4V) programs to the physician network; and work collaboratively with the physician practices that contract into the programs to reinforce and improve quality, to enrich the patient experience and to reduce the overall cost of care for members.
25% - 50%
PHYSICAL, MENTAL DEMANDS AND WORKING CONDITIONS
An employee in this position works in an office environment. The position frequently requires the employee to communicate effectively with others both inside and outside the workplace (e.g., in person, via telephone, via email). The employee must be able to understand, interpret and analyze data, solve problems, concentrate, and research, use available technological resources and systems (e.g., computers and computer programs), multi-task, prioritize, and meet multiple deadlines to complete essential tasks. The employee generally works in a fast-paced and frequently stressful environment, must attend work on a regular and reliable basis as well as adhere to all workplace policies, and may be called upon to work outside regular business hours.
Teaches/Trains others regularly
Travels regularly from the office to various work sites or from site-to-site
Physical Work Site Required
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
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