Participate in strategic commitments of Provider Consulting Services through resolution of provider issues, development of partnerships and education.
Provide comprehensive research and responses for identified problems and complex inquiries related to the provider community.
Develop and implement provider educational sessions on relevant topics such as new business tools, billing, coding, etc.
Assist leaders in monitoring issues, projects, timelines and plans related to various corporate initiatives impacting providers.
Research, analyze, identify and evaluate data to assess existing trends and issues.
Recommend, communicate, and implement solutions to identified problems and root cause of issues.
Provide expertise and guidance to unit and corporate staff as required.
Use clinical expertise and utilization experience to ensure quality of care, propose reimbursement policy revisions and clarify relationship of medical policy to reimbursement and benefit policies for claim administration.
Represent and participate in group or committee discussions.
Other duties may be assigned.
" Qualifications"
Current unrestricted state of Michigan registered nurse license required.
Bachelors degree in nursing or related field preferred.
Five (5) years experience in provider consulting/relations required.
Strong communication skills are required to understand, interpret, and communicate ideas.
Strong knowledge and use of existing software packages (PowerPoint, Excel, Word, etc).
Strong analytical, organizational, planning and problem solving skills.
Ability to effectively interface with employees at all levels.
Ability to understand and apply statistical inference including research principles.
Demonstrated medical and clinical knowledge required to analyze related issues and apply principles to health care business environment.
Other related skills and/or abilities may be required to perform this job.
All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.
Equal Opportunity Employer–minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity
Please see job description for required skills.