Managed Care Provider Relations Manager jobs in Billings, MT

The Provider Relations Liaison is the point person and key liaison between Billings Clinic and referring providers in a designated geographical area. Provides strategy support to administrative and service line leadership for services provided throughout the region. Delivers key Billings Clinic messaging, develop relationships with practice leaders, physicians, and staff, reinforce appropriate utilization of Billings Clinic services, coordinate issue resolution, and act as a liaison between the referring office and Billings Clinic. Qualifies potential referral generating sources, strengthens relationships with existing referral sources, determines provider and patient needs, and effectively communicates solutions. Accountable for referral relations program and communication processes. Develops and coordinates and distributes communications and tools to support the flow of referrals and communication back to referring providers. Gathers and shares local and regional marketing intelligence to support development and implementation of marketing and planning strategies. Engages with Regional Leadership for defined geographic area to support organizational goals. Held accountable to monthly goals and quotas that are determined by leadership.

Essential Job Functions

• Identifies and routinely interacts with targeted referring physicians both locally and in the region. Provides overview of Billings Clinic capabilities and services and provides follow-up to clinical leadership for any service improvements. In collaboration with physician leadership, other medical/ancillary staff and other health care providers, develops and implements short and long range plans, and leads, develops and revises programs which enhance services.
• Assists in the execution of specialty service line marketing plans to retain and increase specialty and tertiary referrals and expand market capture and geographic presence.
• Participates in building relationships to maintain and strengthen both internal and external referral relationships. Gathers market intelligence from region and integrates into planning processes and identifies trends in the market that impact market strategy with local leaders.
• Partners with clinical service line director/manager to clarify and resolve referring physician problems/complaints.
• Assists in the retention of patients from on aspect of care to another in a convenient, customer responsive expedited manner.
• Provides best access to Billings Clinic services.
• Helps Billings Clinic make it easy for patients and providers to enter and stay in our integrated network.
• Gains a deep understanding of the patient and provider experience accessing and staying in Billings Clinic system.
• Understands business needs of referral sources and how Billings Clinic can meet those needs.
• Builds and maintains strong professional relationships and formulates a strategy to increase appropriate utilization.
• Utilizing reports and feedback from internal and external sources.
• Identifies opportunities that gains a deep understanding how services are accessed by patients and providers, and how those services can improve clinical outcomes for patients in our communities.
• Assists leadership in developing assigned territory that fit within the scope of the overall company strategy.
• Identifies opportunities, issues, and sources of leakage.
• Provides communication with leadership to resolve referring office issues and customer service shortfalls.
• Maintains call logs and visit notes as instructed by Outreach leadership.
• Correlates closely with hospital leadership in delivering a standard Billings Clinic message.