Provider Support Specialist
Posted on Apr 8, 2019 by Magellan Health
- Provides orientation, training, education meetings, presentations, and focus groups to improve mutual understanding and enhance working partnerships with providers.
- Works with provider groups to improve quality, outcomes and efficiency and to adopt best practices.
- Assists with brokering the relationship between BH and PH providers.
- Works with our providers to transform data into actionable information at the practice and member level e.g. gaps in care, quality and utilization, etc.
- Offers basic trainings and webinars for providers and office staff re: SPMI population co-occurring disorders, stigma, poverty, disparities, substance abuse, reduce discrimination.
- Performs medical record reviews as needed.
- Responds to provider inquiries via phone, e-mail, secure web messaging.
- Supports processes that address provider complaints, claims, contracting, credentialing and other problems requiring follow-up and resolution.
- Facilitates immediate resolution of red-flag provider issues that are client, community, legal, or contractual threats with internal personnel as needed.
- Assists in development and management of weekly, monthly, quarterly reports.
- Other duties as assigned.
General Job Information
TitleProvider Support Specialist
Job FamilyClinical Services Group
CountryUnited States of America
FLSA StatusUnited States of America (Exempt)
Recruiting Start Date12/6/2018
Date Requisition Created11/29/2018
EducationBachelors: Nursing (Required), Masters: Behavioral Health (Required)
License and Certifications - RequiredLAC - Licensed Associate Counselor - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, LMFT - Licensed Marital and Family Therapist - Care Mgmt, PSY - Psychologist - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt
License and Certifications - PreferredCPHQ - Certified Professional In Healthcare Quality - Care Mgmt
Other Job Requirements
- 5+ in a Healthcare environment.
- Ability to travel regionally 60-75% in field.
- Masters level licensed Registered Nurse (RN).
- Strong knowledge of Medicaid.
- Experience with practice facilitation or provider relations.
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled