This position is field-based with the majority of time spent in provider offices in Volusia and Flagler County
Top Reasons to Work at AdventHealth Corporate
Immediate Health Insurance Coverage
Career growth and advancement potential
Full-Time, Monday â“ Friday
You Will Be Responsible For:
Uses knowledge to help connect key concepts and expectations, ultimately presenting the MSO, Regional Market CIN, and/or affiliated payer networks/health plans, in a manner that is simple for providers to relate to. Regular rounding to communicate messages about the value of solutions, strategies, performance/incentive models, policies, procedures and to timely issue resolution.
On boarding providers for Provider Networks and affiliated payer networks/health plans to ensure provider is informed and engaged related to essential information.
Facilitates practice change management in regards to emerging trends related to population health initiatives, reimbursement models, patient satisfaction, customer outreach, panel growth, and provider performance with quality and efficiency metrics. The Advisor should be seen as an asset to their practices by providing important information closing care gaps remot or iin office, if applicable, and recommending enhancements to help ensure success in the value-based healthcare environment.
Actively participates in continuing education topics for other Population Management Advisors. Suggests topics or items based on conversations occurring in the field or based on other perceived gaps in education.
Responsible for tracking, measuring, analyzing, and reporting on provider contacts, updating provider demographics, validating provider contact information, and reporting issues in the designated provider reporting tool.
Fully understands the provider and ancillary makeup of the provider network, and affiliated payer networks in order to provide relevant feedback and intel related to potential needs.
Responsible for maintaining and understanding assigned territories including market attributes, providers in the community, and other pertinent information.
Works seamlessly, effectively, and in harmony with all internal teams including, but not limited to, MSO, Regional Market CIN, and/or affiliated payer networks/health plans credentialing, provider resolution center, quality and care integration, provider engagement education, and analytics to ensure integrated operations that result in a superior consumer experience for the provider.
Responsible for maintaining operational knowledge of Cerner HealtheIntent or any similar business intelligence tools and assisting providers with understanding and utilization of such tools and engaging other MSO, Regional Market CIN, and/or affiliated payer networks/health plans resources/teams as needed
What You Will Need:
Bachelorâ™s Degree in healthcare, business or a related field; or 6+ years of related experience.
3+ yearsâ™ experience in performance improvement, operations, marketing or in a relevant physician/ hospital/ managed care environment.
3+ yearsâ™ experience working collegially with physicians
Knowledge of hospital and provider (multi-specialty group, IPA or PHO) operations and services impacted by managed care and health care reform
Knowledge about both the clinical and financial aspects of managed care, including capitation and global budgets
Demonstrated basic knowledge of processes within the ambulatory practice/provider setting
Demonstrated experience in preparing and delivering written and oral reports
Strong skills for using various information systems tools to identify performance improvement opportunities, communicate these opportunities to providers and track improvements
Ability to handle difficult and complicated situations and maintain professionalism
An understanding of health plan operations and network quality and efficiency initiatives related to providers, including reporting and attestation of quality measures
The purpose of this position is to provide Population Health subject matter expertise, consultation and education to network providers (market/region dependent) by establishing and maintaining a strong relationship with the provider and practice. Population Management Advisors are expected to make regular visits to provider practice offices, with the intent to advise and educate on a wide variety of topics Examples include population health management strategies and programs, clinical integration, incentive program(s), provider web portals, quality care gap closure efforts, if applicable, and MSO or Regional Market CIN and provider network policies and procedures.
The Population Management Advisor (PMA) is designed to provide value to the network provider and practice through expertise, consultation, change management, and provider engagement. The Population Management Advisor is the relationship manager for the practice and exists to help simplify the providerâ™s experience with the MSO, Regional Market CIN, and/or affiliated payer networks/health plans while working to identify and address improvement opportunities. As part of the MSO or Regional Market Outreach Team, the PMA will be responsible for executing plans as it relates to value-based performance including quality, cost and patient experience opportunities, and delivering key messages to providers and office staff. This position is field-based with the majority of time spent in provider offices.
AdventHealth Greater Orlando (formerly Florida Hospital) is one of the largest faith-based health care providers in the United States. For 150 years, we have carried on a tradition of providing whole-person care that not only addresses patients' physical ailments, but also supports their emotional and spiritual well-being. We demonstrate the same level of compassion and care for our employees as well, doing all that we can to help them realize their full potential – both personally and professionally.