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Sr Provider Partnership Assoc

Job Description

The Provider Network Services Senior Provider Partnership Associate supports Integrated Delivery Health Systems (IDS) and community providers including but not limited to primary care physicians, specialists, ancillary, behavioral health, and institutional providers in Pennsylvania and Delaware.  Independently researches, analyzes, and addresses provider issues and concerns to achieve expected goals/outcomes within the set timeframes.  Proactively educates providers on new initiatives and policy changes that impact their claims payments, including outreach for UM Vendor Management Programs.  Establishes and maintains professional and effective relationships between IBC and network providers to continually improve provider satisfaction.  Ensures the resolution to issues related to complex claims payment, provider data file maintenance, Quality Incentive Payments (QIPS), capitation, and medical policy.  Maintains and updates the appropriate tracking issues database with current statuses and next steps.  Collaborates with other departments within the organization to assist with resolution of complex provider issues.