Urgent! Network Operations Representative Job Opening In Houston – Now Hiring Apex Health Solutions
Summary Position is responsible for establishing, building, and maintaining relationships with the participating physicians of the Houston based Unity Health Partners Healthcare Collaborative and their office staff.
The position assists in contract negotiations, contract management and optimizing a high-performing network of both PCP and Specialty physicians.
The role develops and preserves strong relationships with physicians, office managers and supporting personnel with an eye toward optimizing value-based incentive relationships.
Location Houston, TX Essential Functions include the following.
Other duties may be assigned.
• Provide operational and managerial support to HCC physicians, including but not limited to: Provider Contracting (professional, ancillary and vendor) Shared Savings Quality Incentive Programs Partial and Full Risk-Based Initiatives Provider Information and Credentialing; Provider Relations, Account Management & Education; Data Exchange and Integrity; Reimbursement and Data Analysis; and, Communications and Relationship Management Create and deliver materials to educate physicians and their office personnel with regards to contracts, policies and procedures, quality and service line initiatives, and financial performance.
Serve as the primary liaison for physicians and their practices participating with the HCC in value-based care initiatives.
Establish and maintain a supportive, collegial role with HCC physicians and their practices.
Proactively identify interventions that will facilitate success in practices.
Take appropriate actions to increase revenue, leverage resources, manages and/or minimizes expenses, drive medical expense initiatives and ensure compliance with all regulatory requirements.
Understand, develop, track, monitor and report on key program performance metrics, such as utilization, coding, and STARs/quality performance.
Facilitate resolution related to practice concerns, grievances, claims and care delivery.
Assist in the STARS and clinical metrics data collection, and design plans for enhanced provider engagement in quality initiatives.
Prepare materials and participate in monthly operational meetings with senior leadership.
Partner with other internal departments, including but not limited to Health Services, Medical Economics, Sales, and Quality/Coding in order to develop solutions for strategic business needs.
Support network related activities associated with any expansion initiatives in new markets.
Perform other duties as assigned.
Education • Required: Bachelor's Degree • Preferred: Master's Degree Experience • Required 3+ years of experience in managed care environment, health plan finance, provider network management or managed care consulting.
• At least one year related experience with physician engagement and/or value based reimbursement models.
• Demonstrated knowledge of contracting process, Medicare fee schedules, financial terms, and metrics.
Skills • Knowledge of healthcare delivery • Knowledge of community, state and federal laws and resources • Ability to analyze and interpret financial data and quality information • Ability to work in a fast paced environment with changing priorities • Ability to work with others in a matrixed environment • Ability to work within tight timeframes and meet strict deadlines • Demonstrated leadership skills • Demonstrated time management and priority setting skills • Demonstrated analytical skills • Demonstrated written communication skills • Demonstrated problem solving skills • Demonstrated negotiation skills • Demonstrated interpersonal/verbal and written communication skills • Demonstrated organizational skills • Demonstrated presentation skills • Demonstrated ability to converse with and deliver complex messages to physicians and physician personnel Technical Skills • Required Intermediate Microsoft Outlook • Required Intermediate Microsoft Word • Required Intermediate Microsoft PowerPoint • Required Intermediate Microsoft Excel
✨ Smart • Intelligent • Private • Secure
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Unlock Your Network Operations Potential: Insight & Career Growth Guide
Real-time Network Operations Jobs Trends in Houston, United States (Graphical Representation)
Explore profound insights with Expertini's real-time, in-depth analysis, showcased through the graph below. This graph displays the job market trends for Network Operations in Houston, United States using a bar chart to represent the number of jobs available and a trend line to illustrate the trend over time. Specifically, the graph shows 53131 jobs in United States and 631 jobs in Houston. This comprehensive analysis highlights market share and opportunities for professionals in Network Operations roles. These dynamic trends provide a better understanding of the job market landscape in these regions.
Great news! Apex Health Solutions is currently hiring and seeking a Network Operations Representative to join their team. Feel free to download the job details.
Wait no longer! Are you also interested in exploring similar jobs? Search now: Network Operations Representative Jobs Houston.
An organization's rules and standards set how people should be treated in the office and how different situations should be handled. The work culture at Apex Health Solutions adheres to the cultural norms as outlined by Expertini.
The fundamental ethical values are:The average salary range for a Network Operations Representative Jobs United States varies, but the pay scale is rated "Standard" in Houston. Salary levels may vary depending on your industry, experience, and skills. It's essential to research and negotiate effectively. We advise reading the full job specification before proceeding with the application to understand the salary package.
Key qualifications for Network Operations Representative typically include Other General and a list of qualifications and expertise as mentioned in the job specification. Be sure to check the specific job listing for detailed requirements and qualifications.
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Before the Interview:To prepare for your Network Operations Representative interview at Apex Health Solutions, research the company, understand the job requirements, and practice common interview questions.
Highlight your leadership skills, achievements, and strategic thinking abilities. Be prepared to discuss your experience with HR, including your approach to meeting targets as a team player. Additionally, review the Apex Health Solutions's products or services and be prepared to discuss how you can contribute to their success.
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