Job Description

Position & Unit Accountabilities Develops/Manages Processes & Systems - Assists with contracts; assists in the negotiation of physician managed care contracts, analytics, and financial modeling. Upholds Standards/Expectations of HSS Staff - Coordinates enrollment; coordinates physician enrollment in managed care plans. Upholds Standards/Expectations of HSS Staff - Ensures compliance; ensures compliance of managed care companies with negotiated contracts. Upholds Standards/Expectations of HSS Staff - Resolves payor issues; follows up and resolves payment issues with insurance payors. Upholds Standards/Expectations of HSS Staff - Acts as liaison; acts as a liaison between physician offices and insurance payors. Upholds Standards/Expectations of HSS Staff - Assists with meetings; schedules, coordinates, and documents for all PHO related meetings. Maintains Documentation & Manages Information - Maintains tracking logs; creates and maintains tracking logs for insurance payor issues and accounting for closing out items. Upholds Standards/Expectations of HSS Staff - Oversees PHO line; oversees PHO phone line, answers and responds to inquiries, and assists with urgent physician office issues. Upholds Standards/Expectations of HSS Staff - Attendance; maintains satisfactory attendance record. Upholds Standards/Expectations of HSS Staff - Maintains punctuality; reports for duty punctually. Upholds Standards/Expectations of HSS Staff - Adjusts to change; adjusts to changing situations and work assignments. Physical Working Conditions Continuously stand/walk or lift/handle/carry material or equipment of moderate weight (20 to 50 lbs). Examples: nurses, LPNs, and physical therapists. Environmental Working Conditions Indoor area with frequent exposure to mild physical discomfort from dust, fumes, temperature, and noise. Examples: patient care providers and laboratory technicians. Hazards (OSHA) Category 1 tasks that involve exposure to blood, body fluids, tissues, and other potentially infectious materials. Qualifications Scientific background required. Outstanding record of academic achievement and research experience. 0–2 years required. Proven record of leadership through extracurricular activities or work. Ability to work collaboratively and effectively on a team with people at all levels of an organization. Excellent organization skills (ability to manage several concurrent tasks). Superior oral and written communication skills. Bachelor's degree required. Non-Discrimination Policy Hospital for Special Surgery is committed to providing high quality care and skilled, compassionate, reliable service to our community in a safe and healing environment. Consistent with this commitment, HSS provides care, admits, and treats patients and provides all services without regard to age, race, color, creed, ethnicity, religion, national origin, culture, language, physical or mental disability, socioeconomic status, veteran or military status, marital status, sex, sexual orientation, gender identity or expression, or any other basis prohibited by federal, state, or local law or by accreditation standards. #J-18808-Ljbffr Hospital for Special Surgery

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