The Network Operations Sr. Specialist provides local support to the current Texas ACO and CIO networks through continuous interaction with participating and potential providers, practice office staff, ACO/CIO leadership and Tenet hospital market managers. The Network Operations Sr. Specialist will be responsible for efforts to assure adequate network participation by all provider types: physician, facility, ancillary, etc and will be responsible for leading practice communication and education initiatives with network providers. The position will also be responsible for recruitment and onboarding of new practices as well as ensuring that all committee and board meetings are scheduled and recorded timely and accurately. As part of the practice education and communication responsibilities, this position will support implementation and adoption of the population health tool, improvement in coding/documentation accuracy and reviewing performance reporting on network KPIs. Network operations responsibilities are more specifically defined as follows:
1.Conduct in person on-going training for network practices to include overview of CIN payers, specialty specific quality metrics, education of Population Health Management and Clinical Quality Tools
2.Assist with provider recruitment using standardized recruitment tools and protocols to ensure network adequacy
3.Schedule, prepare material and conduct quarterly office manager meetings
4.Coordinate provider education related to HCC coding/documentation education and other payer quality metrics
5.Onboard new providers to the ACO and CIN networks using approved protocol
6.Identify low performing providers and coordinate provider education plans to ensure compliance with clinical integration program quality metrics
7.Assist with ongoing practice education through targeted small group provider meetings
8.Engage, onboard and/or provide ongoing management to local employers, TPAs or other purchasers who utilize our ACO/CIN network for employee benefits/wellness.
9.Schedule and prepare materials for all applicable network Board and physician committee meetings.
Five yearsï¿½ experience in health care or managed care setting, preferably experience with practice operations, provider relations or network development. Industry experience is non-negotiable. This is a role that requires experience networking with market providers. Also requires Advanced Microsoft Office skills including high level of proficiency in and knowledge of Excel spreadsheets.
Bachelorï¿½s degree in business, health care administration or related field preferred. Additionally, the following skills and knowledge of systems are desired:
Industry Knowledge and Skills
1.High level problem solving skills
2.Ability to present to executive leadership
3.Ability to produce reports and presentations to submit to executive level members
4.Accountable Care Organization, population health and value-based programs
5.Health Plan network adequacy and credentialing process
6.Life cycle of a claim
Primary Location: San Antonio, Texas
Facility: Tenet Headquarters
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Internal Number: 1905043205
About Tenet Headquarters
“Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans.