The Assistant Practice Manager is a professional and knowledgeable individual who will be responsible for the overall operations, development and success of the medical practice. In this important role, the Assistant Practice Manager will be an information resource and ambassador to patients, the general public, Physicians and staff.
Responsibilities:
• Ensure office is opened and closed daily, as per established schedules.
• Interview, hire and train new staff in accordance with HR guidelines.
• Manage daily staffing to ensure optimal operation of the practice.
• Regularly review productivity and make staffing adjustments as needed.
• Monitor and approve time cards and track licensure requirements for staff.
• Conduct regular staff meetings and assist in the annual performance evaluations of practice staff.
• Review accounts receivable reports monthly.
Qualifications:
• Bachelor’s Degree in Healthcare Management or Business Administration preferred or 3+ years experience in medical office management.
• Working knowledge of medical terminology.
• Medical office billing experience preferred
• Proficiency with EMR systems and software applications and Microsoft Office Suite.
• Excellent written and oral communication skills.
• Fluent in Spanish a plus.
Company Benefits:
In a full-time permanent position, you will be able to participate in our company benefit program which includes:
• Group benefits include medical, dental, vision, company paid $25k life with the option to add more voluntary life insurance coverage for employee and their family, STD, company paid LTD, 401k, and a variety of supplemental coverages such as hospital, cancer, legal, etc. available to the employee and their family.
• Employer funded HSA program.
• Paid Time Off ranging from 5-28 days depending on length of service.
• Profit Sharing Bonus Program
• 100% Employer Paid Pension Plan after 5 years
• Employer Sponsored Wellness Program with access to company gym and locker rooms in Houston offices.
• Schedules appointments and retrieving medical records from participating physician offices quarterly either by remote access or field (in physician office) collection. Reports to Chart Collection Manager
Job Duties:
• Contacts physician offices weekly to schedule available appointments to retrieve medical records.
• Must document all activity with doctor’s office or IntegraNet Departments concerning chart collection.
• Confirm collection method (EMR or paper) when scheduling for field collection. Bring appropriate collection materials such as laptop and scanner.
• Confirms appointments the day before a scheduled appointment. Resolve any issues so prospective appointments can be met or rescheduled effectively.
• Updates new appointments daily on the chart collection calendar for physicians and staff.
• Serves as point of contact for physicians and staff concerning chart retrieval for field collection.
• Travels 15% to 20% of time for collection each quarter, this includes Dallas and surrounding areas.
• Coordinates with other departments – Provider Relations, Coding and HEDIS Review as necessary to ensure proper and quality/usable data in the medical records is obtained.
• Must enter mileage each day for field collection.
• Maintains patient confidentiality by keeping patient records information confidential.
• Other job duties as assigned.
• Cross trains with others to ensure department activities can continue without interruption.
Skills and Qualifications:
• Reliable transportation and clear driving records required
• Must pass background check.
• Experienced in Microsoft Office required
• Heavy scheduling experience required
• Strong time management, productivity, organizational skills and attention to detail
• Professional and flexible, Productive, Deadline-Oriented, Reporting Skills required.
• Excellent communication skills
• Ability to work effectively as an individual and/or team, self-starter
• Bilingual - Spanish
• Experience reviewing medical records and imaging studies in multiple medical record platforms
• Critical thinking and problem-solving skills
• The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms; The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
• This is a full-time position, and general hours are Monday through Friday, 8:00 a.m. to 5:00 p.m.
• This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, printers, and filing cabinets.
Company Benefits:
• In a full-time permanent position, you will be able to participate in our company benefit program which includes:
• Group benefits include medical, dental, vision, company paid $25k life with the option to add more voluntary life insurance coverage for employee and their family, STD, company paid LTD, 401k, and a variety of supplemental coverages such as hospital, cancer, legal, etc. available to the employee and their family.
• Employer funded HSA program.
• Paid Time Off ranging from 5-28 days depending on length of service.
This position serves as an integral member of the Quality and Provider Relations Team and reports to the designated Market Lead of Employer (IPA). This role is a key contributor to the training of providers and their staff on HEDIS and GPRO measures and is accountable for all providers achieving a minimum of 4-STAR for HEDIS and 95% quality for GPRO as well as other duties as assigned by the Market Lead. This is a field position requiring travel to doctors’ offices regularly.
Responsibilities:
Advises and educates providers and their staff in the appropriate documentation of HEDIS and GPRO measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements.
Collects, summarizes and trends provider performance data to identify and strategize opportunities for provider improvement.
Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters).
Delivers provider specific metrics and coaches Providers on gap closing opportunities.
Identifies specific practice needs where IntegraNet Health can provide support.
Leads and/or supports collaborative business partnerships, promote client understanding and insight to advise and make recommendations.
Partners with physicians/physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education.
Provides resources and educational opportunities to provider and staff.
Captures concerns and issues in action plans as agreed upon by provider and in formats approved by IPA.
Documents action plans and details of visits and outcomes and reports critical incidents and information regarding quality of care issues.
Communicates with external data sources as authorized to gather data necessary to measure identified outcomes.
Provides IPA approved communication such as newsletter articles, member education, outreach interventions and provider education.
Supports Provider office-based quality improvement and program studies as needed, requesting records from providers, maintaining databases, and researching to identify members' provider encounter history.
Ensures that documentation produced and/or processed complies with state regulations and/or accrediting body requirements.
Ensures assigned contract/regulatory report content is accurate and that submission adheres to deadline.
Participates in and represents IPA at community, health department, collaborative and other organizational meetings focusing on quality improvement, member education, and disparity programs, as assigned.
Works with office-based staff to ensure accuracy in medical records for data collection, data entry and reporting. Enters documentation of findings in identified databases.
Performs other duties as assigned.
Qualifications:
Licensed Vocational Nurse (LVN) or Licensed Registered Nurse (RN)
5+ years working with HEDIS and GPRO with an IPA or health plan in a senior role.
Knowledge of computer systems and applications. Skill in planning, organizing, prioritizing, delegating and supervising.
Skill in exercising initiative, judgment, problem-solving, decision-making.
Skill in identifying and resolving problems.
Ability to anticipate and react calmly in emergency situations.
Skill in developing and maintaining effective relationships with medical and administrative staff, patients and the public.
Skill in developing comprehensive reports.
Ability to analyze and interpret complex data.
Skill in developing and maintaining office-based quality improvement.
Excellent and effective written and verbal communication skills.
Company Benefits:
In a full-time permanent position, you will be able to participate in our company benefit program which includes:
Group benefits include medical, dental, vision, company paid $25k life with the option to add more voluntary life insurance coverage for employee and their family, STD, company paid LTD, 401k, and a variety of supplemental coverages such as hospital, cancer, legal, etc. available to the employee and their family.
Employer funded HSA program.
Paid Time Off ranging from 5-28 days depending on length of service.
Profit Sharing Bonus Program
100% Employer Paid Pension Plan after 5 years
Employer Sponsored Wellness Program with access to company gym and locker rooms in Houston offices, if applicable.
This position serves as an integral member of the Quality and Provider Relations Team and reports to the designated Market Lead of Employer (IPA). This role is a key contributor to the training of providers and their staff on HEDIS and GPRO measures and is accountable for all providers achieving a minimum of 4-STAR for HEDIS and 95% quality for GPRO as well as other duties as assigned by the Market Lead. This is a field position requiring travel to doctors’ offices regularly.
Responsibilities:
Advises and educates providers and their staff in the appropriate documentation of HEDIS and GPRO measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements.
Collects, summarizes and trends provider performance data to identify and strategize opportunities for provider improvement.
Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters).
Delivers provider specific metrics and coaches Providers on gap closing opportunities.
Identifies specific practice needs where IntegraNet Health can provide support.
Leads and/or supports collaborative business partnerships, promote client understanding and insight to advise and make recommendations.
Partners with physicians/physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education.
Provides resources and educational opportunities to provider and staff.
Captures concerns and issues in action plans as agreed upon by provider and in formats approved by IPA.
Documents action plans and details of visits and outcomes and reports critical incidents and information regarding quality of care issues.
Communicates with external data sources as authorized to gather data necessary to measure identified outcomes.
Provides IPA approved communication such as newsletter articles, member education, outreach interventions and provider education.
Supports Provider office-based quality improvement and program studies as needed, requesting records from providers, maintaining databases, and researching to identify members' provider encounter history.
Ensures that documentation produced and/or processed complies with state regulations and/or accrediting body requirements.
Ensures assigned contract/regulatory report content is accurate and that submission adheres to deadline.
Participates in and represents IPA at community, health department, collaborative and other organizational meetings focusing on quality improvement, member education, and disparity programs, as assigned.
Works with office-based staff to ensure accuracy in medical records for data collection, data entry and reporting. Enters documentation of findings in identified databases.
Performs other duties as assigned.
Qualifications:
Licensed Vocational Nurse (LVN) or Licensed Registered Nurse (RN)
5+ years working with HEDIS and GPRO with an IPA or health plan in a senior role.
Knowledge of computer systems and applications. Skill in planning, organizing, prioritizing, delegating and supervising.
Skill in exercising initiative, judgment, problem-solving, decision-making.
Skill in identifying and resolving problems.
Ability to anticipate and react calmly in emergency situations.
Skill in developing and maintaining effective relationships with medical and administrative staff, patients and the public.
Skill in developing comprehensive reports.
Ability to analyze and interpret complex data.
Skill in developing and maintaining office-based quality improvement.
Excellent and effective written and verbal communication skills.
Company Benefits:
In a full-time permanent position, you will be able to participate in our company benefit program which includes:
Group benefits include medical, dental, vision, company paid $25k life with the option to add more voluntary life insurance coverage for employee and their family, STD, company paid LTD, 401k, and a variety of supplemental coverages such as hospital, cancer, legal, etc. available to the employee and their family.
Employer funded HSA program.
Paid Time Off ranging from 5-28 days depending on length of service.
Profit Sharing Bonus Program
100% Employer Paid Pension Plan after 5 years
Employer Sponsored Wellness Program with access to company gym and locker rooms in Houston offices, if applicable.
A Patient Outreach Representative is responsible for ensuring all new patients connect with their Primary Care Physician and they understand their benefits, preventive services obligations and questions regarding their Welcome Packet. They also perform surveys, send Welcome letters and follow up letters and postcards as needed. They assist patients with selecting a new PCP when needed and ensure that all departments are informed of patient needs or assist in locating the appropriate resources to assist the patient in achieving a high feeling of satisfaction. Travel requirements – minimal. Must be bi-lingual.
Responsibilities
Included in this role you will be expected to:
Review patient reports each month to identify new patients or PCPs/Spec incorrectly listed
Contact new patients for education on PCP identification, obtaining the Welcome Packet
Follow-up calls to patients to see if they connected with their Primary Care Physician and to survey their satisfaction, and understanding of the Welcome Packet material
Perform satisfaction surveys of PCPs, Health Plans
Perform reminder calls for Medication Adherence, mail order options, to contact PCPs if hospitalized, HEDIS Gaps
Perform phone calls to patients for assistance with selection of another PCP when physicians term
Act as a liaison between departments so each department can perform duties necessary for patient satisfaction and department accountability
Provide advice/guidance/recommendations and insight to leadership
Serves as a resource to others
Packet assembly and correspondence
Assist Health Plans and Physicians with HEDIS compliance and data collection when needed
Assist with special projects as needed
Qualifications
High School diploma or GED equivalent
1-3 year experience in Healthcare
Knowledge of claims processing systems and guidelines a plus
Must be bi-lingual
Strong interpersonal skills, establishing rapport and working well with others.
Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
Familiar with Microsoft applications including Outlook, Word and Excel. Experience with Access a plus.
Must be self-motivated and work independently; able to translate concepts into practice
Ability to Multi-Task
Decision-Making – must be able to work independently and made decision that the company, physician and patient needs
The Provider Relations Representative is responsible for establishing and maintaining strong business relationships with provider types, ensuring each of their territory compositions include an appropriate distribution of provider specialties and provide in depth, high level educational instruction and support to physicians and their staff. This is an account management position and will be the main point of contact for the respective providers. Will routinely visit physician’s offices for issues concerning the achievement of provider satisfaction, medical cost targets, network growth and/or efficiency targets, education of benefits, policy and procedure for managed care plans, assistance with claims payments, financial compensation and marketing. Generally, work is self-directed and not prescribed; works with less structure, but more complex issues. Travel requirements – local and extensive.
Responsibilities:
Develop the provider network of assigned territory (family practice, cardiology, etc.) yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management, and produce a comprehensive product for business partners.
Intermediary between Health Plans and Providers concerning provider participation, claim issues, additions, terminations
Daily visits to physician offices
Provide Orientations and ongoing education to physicians and staff on Health Plans policies, procedures and resource information
Develop a strong relationship with office staff and physician to promote their growth in the network.
Review bonus matrix with physicians for each quarterly distribution.
Proven ability to synthesize and translate competitive intelligence into decision-making process
Analyze Data to identify cost driver and share/educate physicians on improvement options
Provide advice/guidance/recommendations and insight to leadership regarding assigned network territory
Negotiates provider contracts as applicable
Participates in quarterly Provider Forums
Serves as a resource to others.
Assist staff with proper claims payment when necessary.
Assist Health Plans and Physicians with HEDIS compliance and data collection
Works with other departments on a daily basis
Assist with special projects
Qualifications:
2+ years of experience in Provider Relations with a Physician Network or Health Plan (4+ for Senior) REQUIRED
Knowledge of Medicare Managed Care REQUIRED
Knowledge of CMS Medicare Advantage Risk Adjustment, Star rating program, and HEDIS preferred
Knowledge of Direct Medicare record collection and understanding of ICD9/ICD10, CPT 4 billing requirements preferred
Reliable transportation REQUIRED
MUST live in the recruiting area
Fluent in Spanish a plus
Knowledge of claims processing and guidelines a plus
Strong interpersonal skills, establishing rapport and working well with others
Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others (a critical thinker with presentation skills)
Analytical/data drive decision-making skills
Working knowledge of provider business operations
Proven ability to synthesize and translate competitive intelligence into decision-making process
Familiar with Microsoft applications including Outlook, Word and Excel. Experience with Access a plus.
Must be self-motivated and work independently; able to translate concepts into practice
Company Benefits:
In a full-time permanent position, you will be able to participate in our company benefit program which includes:
Group benefits include medical, dental, vision, company paid $25k life with the option to add more voluntary life insurance coverage for employee and their family, STD, company paid LTD, 401k, and a variety of supplemental coverages such as hospital, cancer, legal, etc. available to the employee and their family.
Employer funded HSA program.
Paid Time Off ranging from 5-28 days depending on length of service.
Profit Sharing Bonus Program
100% Employer Paid Pension Plan after 5 years
24/7 access to company gym and locker rooms in Houston offices.