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Professional, Facility Relations

Rochester Office, Rochester, New York, United States of America Req #284
Monday, September 9, 2019
Be a part of the transformation at MVP Health Care®. MVP Health Care is a nationally-recognized, regional not-for-profit health insurer. We care for more than 700,000 members across New York and Vermont and are powered by the ideas and energy of more than 1,700 employees. We employ talented people  with diverse backgrounds and experience—tech people, numbers people, even people people—to make health insurance more convenient, more supportive, and more personal. If you’re ready to join a thriving, mission-driven company where you can create your own opportunities—it’s time to make a healthy career move to MVP.
Professional, Facility Relations

Status: Full-time, Exempt: Yes


This position supports the Network Management Strategy in maintaining positive, cooperative relationships with facilities’ and IPA’s billing administrators and support personnel.  Orients facility and IPA staff on MVP Health Care policies and procedures.  Identifies, tracks and trends issues identified by employees, facility staff, and assists with resolution.  Assists the Communications Department in developing and communicating information to facilities’ billing administrators.  Performs other duties as assigned.

POSITION QUALIFICATIONS

Minimum Education: BA degree preferred in Business Administration or related field.

Minimum Experience:  Three years customer service experience in a managed care or medical office practice setting.  Experience interacting with providers required.  

Required Skills:
Familiarity with physician office practice procedures, preauthorization and referral issues, fee policy and billing processes, the provider grievance and appeal process, physician performance reporting.
Excellent communication and interpersonal skills, including the ability to negotiate, interact face-to-face and over the telephone with customers.
Demonstrated strong presentation and facilitation skills.• Ability to effectively handle difficult interpersonal situations.
Demonstrated strong written skills, including the ability to create letters and other communications to providers.
Understanding of the following reimbursement models: RBRVS fee schedule, Inpatient DRG, RUGS (SNF), Outpatient APC, Outpatient ASC, Laboratory, and other MVP fee schedules
Ability to administer multiple Facility Contracts. Must have reliable transportation, moderate amount of travel to provider offices within MVP’s service area.
Strong computer skills (Word, PowerPoint, Excel).
Neat, well-groomed, professional appearance with positive, enthusiastic attitude.
Able to demonstrate strong relationship building skills. # ZIP

MVP Health Care is an Affirmative Action/Equal Opportunity Employer (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com.

Other details

  • Job Family Network Management & Development
  • Pay Type Salary
  • Rochester Office, Rochester, New York, United States of America