The Provider Services Manager (PSM) serves as the first point of contact for assigned providers. The PSM assists the Director of Provider Services with network development, provider recruitment and retention, and the development of sustainable business models that support the safety net providers. The PSM educates and trains providers on work flow, processes and information technology. The PSM works with PCC clinical support programs to develop and spread processes that are effective for providers and PCC programs alike.
The PSM position reports to the Director of Provider Services, on a team of PSMs. The PSM has no direct reports, though has significant responsibility for a provider network and/or to a PCC program area. The PSM is a subject matter expert in an area pertinent to a PCC network or Program.
PSMs assigned to the Specialty Care Network have significant provider recruitment and provider training responsibilities. The PSM-Specialty Care works with the Specialty Care Program Team to identify immediate and long term recruitment needs to address network adequacy and develops and executes recruitment and retention activities. A PSM-Specialty Care is the interface between PCC specialty care programs and providers to listen to provider and program needs, streamline and document processes, and train providers.
Through training or certification, the PSM has expertise in EHR Practice Management, Front Desk solutions, and /or information technology through which providers conduct operations, and capture and use data. The PSM conducts process improvement and training with providers to improve business or clinical outcomes and ensure clean capture of data to fuel improvement cycles.
Develop, manage, and sustain strong provider relationships with network providers.
Establish open communication through regular and meaningful interaction by the use of written communication, in-person/virtual meetings, and provider outreach.
Conduct initial and ongoing orientations of providers and staff to PCC programs and services. Ensures knowledge of contact points, program criteria and procedures.
Ensure providers are well informed about program requirements, network changes, policies and procedures and new initiatives.
Facilitate communication with all essential parties regarding provider requests, issues, and problems for assistance from pertinent others for resolution.
Utilize experience and judgment for effective problem resolution within areas of expertise.
Respond to all provider issues within measured provider satisfaction levels.
Assist in the identification, development, and implementation of strategies relating to the expansion and management of a provider network. With Director, manage provider contracting and renewals.
Track and monitor network providers to ensure Service Provider Agreement compliance.
Create network provider policies and procedures in conjunction with appropriate stakeholders; ensure understanding, compliance, implementation and ongoing effective use of policies and procedures. Provide assistance as needed internally within PCC to program managers/coordinators as network/provider policy relates to program operations.
Generate reports as needed to measure network results and to meet stakeholder reporting requirements.
Provider Effectiveness and Sustainability
Ensure network providers are most effectively utilizing EHR and other technology. Provide EHR systems user training, system configuration support, development of templates, operational and workflow assistance. Analyze and problem solve EHR, software, systems, and technical issues as identified by providers.
Ensure network providers have work flow and data capture processes in place such that electronic systems are an accurate reflection of clinical and business operations and patient care.
Assist network providers in utilizing data, from internal and external sources, to develop improvement plans or make sound business decisions.
Conduct process improvement activities, in conjunction with network providers and PCC Program Managers, to improve effectiveness and efficiency of PCC programs for providers and their patients.
Where appropriate, conduct process improvement activities, in conjunction with network providers, to improve sustainability of the providers’ business models.
Participate on network business development and strategy workgroups
As needed, manage subcontractors for provider sustainability activities.
Implement and monitor growth and sustainability plans as developed by Provider Services team.
Programs Compliance Support
Conduct meeting requirements of program compliance and initiatives.
Assist with generation of reports and measures as required by programs and requested from providers.
Assist program to monitor and improve communication, processes, and overall PCC program performance through regular reports and meetings with program managers.
PSMs – Specialty Care Network have Subject Matter Expertise in the following areas:
Recruitment of specialty care providers to a network that serves low income, uninsured individuals and assist with growth of a comprehensive provider network.
General technical support for EHR and/or other IT systems used by both network providers and PCC programs.
Support for program(s) most closely related to the PSM’s Specialty Provider network(s), materials, trainings, policies and procedures to improve work flow between providers and PCC Program.
Process Improvement, including process mapping and change management.
Participates fully and collaboratively in staff and team work groups.
Participate on PCC workgroups of interest or as assigned.
Represent PCC Programs as assigned in a professional and informed manner resulting in the maintenance and/or establishment of key measures.
Assist with proposal development and program design for future grants and projects.
Other duties as need or as assigned
EDUCATION AND EXPERIENCE
Bachelor’s Degree in Public Health, Healthcare Administration, Business Administration or related field required. Master’s degree preferred.
Three to five years program management experience in health or social service agency.
Three to five plus years’ experience in provider relations and/or network management.
Experience in a medical practice or with an EHR.
Knowledge of eClinical works (eCW) or similar EHR or practice management product strongly preferred.
Demonstrated capacity to assess data for accuracy, trends, outliers or other indicators of improvement need.
Experience developing program plans, reports, and conducting professional communications through email, voice and in person contacts.
Training in process improvement, data analysis or research desirable.
SKILLS AND ABILITIES
Strong interpersonal skills. Ability to interact effectively and build collaborative relationships with diverse clients, stakeholders and staff members at all levels.
Strong oral and written communication skills.
Proven project management skills including attention to detail, with focus on total project completion.
Ability to prioritize work and allocate limited resources resulting in the completion of high quality, customer-focused projects, meetings, reports and analyses.
Ability to manage time effectively and demonstrate good judgment and problem solving skills.
Strong computer skills in Microsoft Office, Word, Excel and Power Point. Familiarity with data management systems and ability to learn new systems and applications.
Ability to conduct research, analyze and interpret data and develop fact-based reports.
Critical thinking strategies to review data, present ideas, and information.
This job operates in a professional office environment. The physical demands described EHRe are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
This role routinely uses standard office equipment such as computers, telephones, photocopiers, filing cabinets and fax machines.
This is largely a sedentary role; however, some filing may be required.
This would require the ability to lift files, open filing cabinets and bend or stand as necessary.
Advanced math skills needed to calculate compensation, bonuses, benefits analysis, percentages, etc.
Requires ability to learn new software applications as necessary
Must be able to lift up to 20 pounds.
May require occasional travel.
This job description indicates in general the nature and levels of work, knowledge, skills, abilities and other essential functions (as covered under the Americans with Disabilities Act) expected of an incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of an incumbent. An incumbent may be asked to perform other duties as required.
The Primary Care Coalition of Montgomery County, Maryland was founded in 1993 when a group of physicians and health care officials imagined a Montgomery County where every resident had access to high-quality health services. They envisioned a dependable source of primary care for low-income, uninsured individuals in our community and created a framework that shared the responsibility for providing... that care across the public and private sectors. The Primary Care Coalition (PCC) was formed to help make their vision a reality.
The mission of PCC is to be the catalyst for developing and coordinating a community-based healthcare system that strives for universal access and health equity for underserved community members. The vision of PCC is that all community members have the opportunity to live healthy lives, and that Montgomery County will be the healthiest community in the nation and a model for providing access to high quality and efficient care for all.