Provider Services Specialist - Community Care of Wake & Johnston Counties
LOCATION: Raleigh, NC
PROGRAM: CCWJC
REPORTS TO: Director of QI/Practice Support
CLASSIFICATION: Full-time, Non-exempt
Position Summary:
The Provider Services Specialist serves as a point person for practices, helping them to succeed in providing high quality, patient-centered care. This position works collaboratively with WCMSCHF team members to provide the necessary education, tools, and resources to our practices that serve our patient populations.
Job Duties:
Serves as point person for primary care practices (PCPs) and key specialists through the following functions:
- Proactively develops and maintains strong provider relations to increase participation and engagement with CCWJC/CCNC through regular visits and other forms of outreach
- Provides education to providers with tools and resources to meet needs of the population through best practice guidelines, practice management support, and/or with other appropriate resources in order to promote quality and cost-effective outcomes
- Actively conducts recruitment outreach to enroll eligible practices with CCWJC/CCNC regarding various efforts and/or initiatives
- Provides data analysis, interpretation and graphing as required to meet practice needs
- Delivers provider and practice education presentations, including new practice orientations, practice refreshers, in-services on CCWJC/CCNC programs and initiatives, and other information as needed
- Promotes and attends Practice Manager and Provider meetings to ensure understanding of information for dissemination to PCPs
- Attends meetings that allow for networking with providers and other important contacts for CCWJC/CCNC
- Maintains updated practice information in designated database on a regular basis to include, but not limited to, number of physicians, operation hours, type of medical record system, etc.
- Educates network practices and other community partners on Carolina Access recipient eligibility and enrollment process
- Fosters relationships and maintains communication with multiple disciplines including CCWJC Care Management and Pharmacy Teams, CCNC Central Office staff, DHHS/DMA, and regional/local Managed Care Representatives
- Maintains patient and family confidentiality in accordance with HIPAA
- Represents the network in a professional manner at all times
- Other job duties as required
Qualifications:
- Bachelor’s Degree highly preferred, OR Assoicates Degree with two year’s of eqivalent work experience, OR minimum of five year’s of equivalent work experience
- Experience in communications/marketing
- Experience in data analysis & interpretation highly preferred
- Experience in working with medical practices is highly preferred
- Experience in quality reporting/EHR technical assistance is highly preferred
- Reliable, personal vehicle is required for travel between work sites
- Must possess a valid driver’s license
Knowledge, Skills and Abilities (KSAs):
- Effective communication (oral and written), interpersonal and customer services skills
- Some knowledge about Medicaid, healthcare payment, and governance
- Analytical skills, sound judgment and self-direction are necessary as independent decisions and problem solving are required
- Strong computer skills required including fluency in Microsoft Office applications – Word, Excel, PowerPoint, etc.
- Highly organized; able to manage multiple tasks and projects
- Flexibility to adapt to shifting priorities and short-term deadlines
- Detail-oriented with excellent time management skills
- Familiarity with data analysis and interpretation with ability to communicate results in both verbal and written formats in an appropriate manner based on target audience as determined by specific functions of the role.
- Familiarity with QI methodologies such as the Model for Improvement with rapid cycle PDSAs and other evidence-based strategies and techniques
- Public speaking in front of people from multiple disciplines is required
Working Conditions:
- The job environment is primarily a combination of office, work at home, and medical facility environments
- Exposure to general office conditions as well as communicable diseases could occur
- Exposure to general office and household conditions including minor physical inconveniences, discomfort in the work setting, or sitting for moderate periods of time
- Travel is required in personal automobile and could vary between 20-80% of time per week
- There is occasional lifting of 20-30 pounds necessary to complete a task
- Evening and weekend work may be required at times, with advance notice and corresponding adjustment in work week schedule or approval of overtime in advance
The above statements are intended to describe the general nature and level of work performed by those assigned to this position. They are not to be construed as an all-inclusive list of duties, skills, and responsibilities of those so assigned.
Interested applicants should send their resume to: Atha Gurganus at agurganus@wakedocs.org. If you are selected for an interview, we will contact you directly.
WCMSCHF is an Equal Opportunity Employer.