Provider Relations Contracting Consultant

Relationship Management Denver, Colorado


Description

Position at Clear Spring Health

Group1001 is a consumer-centric, technology-driven family of insurance companies on a mission to deliver outstanding value and operational performance by combining financial strength and stability with deep insurance expertise and a can-do culture. Group1001’s culture emphasizes the importance of collaboration, communication, core business focus, risk management, and striving for outcomes. This goal extends to how we hire and onboard our most valuable assets – our employees.

Group1001 is a consumer-centric, technology-driven family of insurance companies on a mission to deliver outstanding value and operational performance by combining financial strength and stability with deep insurance expertise and a can-do culture. Group1001’s culture emphasizes the importance of collaboration, communication, core business focus, risk management, and striving for outcomes. This goal extends to how we hire and onboard our most valuable assets – our employees.

Company Overview:

Clear Spring Health is part of Group One Thousand One (“Group1001”), a customer-centric insurance group whose mission is to make insurance more useful, intuitive and accessible so that everyone feels empowered to achieve financial security. Clear Spring Health is dedicated to helping seniors protect their health and well-being by providing Medicare Advantage plans in select counties of Colorado, Illinois, North Carolina, and Virginia, plus Georgia and South Carolina and offers Medicare Prescription Drug Plans in 42 states plus DC.

Group 1001, and its affiliated companies, is strongly committed to providing a supportive work environment where employee differences are valued. Diversity is an essential ingredient in making Group 1001 a welcoming place to work and is fundamental in building a high-performance team. Diversity embodies all the differences that make us unique individuals. All employees share the responsibility for maintaining a workplace culture of dignity, respect, understanding and appreciation of individual and group differences.


Job Summary

The Provider Relations Contracting Consultant supports Clear Spring Health’s business strategy by ensuring a competitive network, strategically approaching the provider community, educate providers, and prioritize network needs both qualitatively and quantitatively and develop and manage successful provider relationships to facilitate new business opportunities and retention.

Main Accountabilities

  • Function as the single point of contact for all contractual and service matters to all facility, group practices, physicians, and other ancillary professional.
  • Facilitate Provider education and as an on-going basis, train the providers to increase their familiarity and satisfaction with Clear Spring Health systems and strategies.
  • Develop trend analysis and analyze provider’s performance to be used for decision-making purposes and improving the quality of care.
  • Working collaboratively with the MRA department in the education efforts of the provider network to optimize accurate and appropriate documentation and coding.
  • Liaise with Market Sales to support retention and growth efforts.
  • Interface with market leaders to align contracting needs and business efforts.
  • Set targets and priorities to meet market network needs.
  • Other Projects and tasks as assigned

Key Competencies

  • Builds Trust: You honor your word by doing what you say you are going to do; manages self and relationships effectively, through self-awareness, self-management, awareness of others and skills in dealing with others.
  • Reporting and Analysis: You can understand and analyze financial information and be able to provide recommendations for improvement.
  • Implementation and Execution: You are good at managing multiple priorities and/or projects by using appropriate methodologies and tools.
  • Innovation: You introduce new ideas and processes which improve performance and productivity.
  • Problem Solving: You proactively identify and correct the root cause of problems to prevent issues from recurring and can encourage others in collaborative problem solving.

Qualifications:

  • Prior demonstrated experience in the health solutions industry
  • Effectively manages multiple priorities
  • Proficient knowledge of Microsoft Office applications with emphasis in Excel and Word
  • A valid Driver's license and an automobile are required for this role
  • up to 50% interstate local travel 
  • Training and/or Experience in Public speaking