Job Information
Magellan Health Services Provider Engagement Specialist- Tribal Outreach Liaison in Boise, Idaho
Tribal Outreach Liaison, ideally hired from within an Idaho Tribal Nation or extensive experience working directly with tribal governments.
Tribal healthcare experience preferred.
The Liaison will be the primarily Magellan point of content for Idaho Tribes and be responsible for regular outreach, engagement, and problem solving with tribal communities, and shall also develop a tribal communities outreach and engagement plan.
Responsibilities include building and maintaining an adequate provider network to meet the needs of the member population. Monitoring and reporting on network adequacy (geo access), recruitment of new providers (sending and negotiating provider agreements), establishing and maintaining strong relationships with providers, provider education and training, and provider issue resolution. Duties also include provider site visits, in-person & virtual provider meetings, and representing network on client meetings.
Recruit new providers and document recruitment efforts.
Negotiate reimbursement rates with providers in accordance with set rate parameters.
Responsible for timely turnaround of agreements in accordance with the company and client standards.
Act as liaison between Clinical, Quality, and Network and the provider community, sharing provider feedback to internal groups, identifying best practices and driving collaboration.
Represent Magellan at client meetings, community events, conferences, and advocacy groups (in-person and virtually).
Communicate extensively (by telephone, in-person, and email) with Providers for support, issue resolution, and collaboration.
Provide orientation, education, training, and support to Magellan contracted providers on Magellan systems, policies, requirements, online tools, and resources.
Report on network initiatives, network adequacy, network trends, and recruitment to Network Management and internal Magellan teams.
Provide summary and problem specific feedback information, analysis and action recommendations to management and relevant functional units regarding provider problems, issues, and general concerns impacting working relationships.
Collaborate with internal Magellan teams (Clinical, Quality, Network) to implement and drive regional and corporate initiatives.
Other duties as assigned by management.
Other Job Requirements
Responsibilities
2+ years' experience in a Customer Care/Healthcare environment with experience in eligibility, authorization and claims problem resolution.
2+ years' experience in network development with demonstrated focus on contracting and rate negotiation.
Excellent organizational and rate negotiation skills required.
Ability to handle multiple tasks simultaneously.
Must be customer service oriented.
Must be a team player.
Must be able to maintain provider confidentiality at all times.
Must demonstrate effective problem solving skills.
Must have excellent verbal and writing skills.
Must have working knowledge of Microsoft Office suite and data entry experience .
General Job Information
Title
Provider Engagement Specialist- Tribal Outreach Liaison
Grade
23
Work Experience - Required
Customer Service, Healthcare, Network
Work Experience - Preferred
Education - Required
Education - Preferred
Bachelor's
License and Certifications - Required
License and Certifications - Preferred
Salary Range
Salary Minimum:
$53,125
Salary Maximum:
$84,995
This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.
This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.
Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.
Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .
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