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Cohere’s Provider Success program is responsible for ensuring consistent delivery of a proactive, supportive, and partner-oriented experience to an regionally assigned group of providers/practices across our health plan-clients' networks (e.g. orthopedic specialists, primary care, ancillary service providers, health systems, etc.). The Provider Success Manager will be an integral member of the Customer Success team ensuring at the elbow partnerships engaging trust and producing loyalty with our Provider Partners.
The Provider Success Manager position is a crucial role in our organization. In this role, you are responsible for managing a defined portfolio of healthcare provider practices and/or health systems in one or more specialty areas. You will serve as the face of Cohere, responding to escalations and questions for your portfolio. Additionally, you will play a proactive role in driving positive change in provider clinical practice patterns by implementing a number of outbound educational and intervention-based campaigns designed by your clinical counterparts.
Key Responsibilities:
Serve as the practice’s main point of contact
Contracting/administrative issues, non-tech-support-like platform questions, training support, tactics to optimize auto approval rates.
Be the subject matter expert for our Provider Partners with the Cohere Unify platform.
Help with onboarding and training new Providers registering on our platform.
Escalation points
Grievance investigation and resolution
Disagreement with clinical guidelines
Authorization processes and training
Proactive outbound engagement:
Identifying non-adherence within portfolio, then designing simple outbound email, phone, and/or educational campaigns to drive favorable behavior change
Sharing best practices, tips to optimize auto approval rates
Portfolio performance monitoring/scorecarding:
Leverage standard reporting packages to monitor assigned portfolio, then identify issues, risks, or opportunities to further clinical quality and trend goals, AND reduce manual review of auth transactions (Cohere admin expense reduction)
Drive routine process (quarterly meetings, routine phone check-ins, etc. to push practices towards achieving optimal auto approval rates, reduce pends and denials
Consultative support:
Support practices seeking to optimize their clinical protocols and/or prior auth admin workflows to better leverage the benefits of Cohere (e.g. increase auto approval rates, decrease follow-up requests for missing information, etc.)
For high-value strategic practices, disseminate relevant thought leadership
Engage practice leadership consultatively as it relates to configuration of Cohere to further practice financial goals (e.g. aligning Care Paths with any risk/procedure-based payment bundles; optimizing flow of patients to internal ancillary services, when aligned with Cohere’s client’s financial/clinical goals)
Consult on better prior auth workflows in Cohere to improve review times
Network implementation support:
Support initial implementation of new client networks
Onboard new providers/practices in mass, and periodically thereafter.
Desired Profile:
Ability to constantly prioritize a large regionally assigned group of practices and independently allocate effort to the highest impact activities.
Experience working with healthcare provider data and networks.
Demonstrated expertise in data preparation and analysis using Google, Excel, Access and other Microsoft applications.
Prior experience managing mid to large scale projects.
Strong Attention to Detail
Bachelor's degree
Minimum 5 years of previous experience in the health solutions industry in a similar account management, client services, provider relations, network operations, or network development role
Must be passionate about contributing to a culture that values consistent delivery of a proactive, supportive, and partner-oriented experience to an assigned portfolio of providers/practices.
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The Provider Success Manager will be an integral member of the Customer Success team ensuring at the elbow partnerships engaging trust and producing loyalty with our Provider Partners.</p><p class=\"ql-align-justify\"><br></p><p class=\"ql-align-justify\">The Provider Success Manager position is a crucial role in our organization. In this role, you are responsible for managing a defined portfolio of healthcare provider practices and/or health systems in one or more specialty areas. You will serve as the face of Cohere, responding to escalations and questions for your portfolio. Additionally, you will play a proactive role in driving positive change in provider clinical practice patterns by implementing a number of outbound educational and intervention-based campaigns designed by your clinical counterparts.</p><p class=\"ql-align-justify\"><br></p><p class=\"ql-align-justify\"><strong>Key Responsibilities:</strong></p><ul><li>Serve as the practice’s main point of contact</li><li>Contracting/administrative issues, non-tech-support-like platform questions, training support, tactics to optimize auto approval rates.</li><li>Be the subject matter expert for our Provider Partners with the Cohere Unify platform.</li><li>Help with onboarding and training new Providers registering on our platform.</li><li>Escalation points</li><li class=\"ql-indent-1\">Grievance investigation and resolution</li><li class=\"ql-indent-1\">Disagreement with clinical guidelines</li><li class=\"ql-indent-1\">Authorization processes and training</li><li>Proactive outbound engagement:</li><li class=\"ql-indent-1\">Identifying non-adherence within portfolio, then designing simple outbound email, phone, and/or educational campaigns to drive favorable behavior change</li><li class=\"ql-indent-1\">Sharing best practices, tips to optimize auto approval rates</li><li>Portfolio performance monitoring/scorecarding:</li><li class=\"ql-indent-1\">Leverage standard reporting packages to monitor assigned portfolio, then identify issues, risks, or opportunities to further clinical quality and trend goals, AND reduce manual review of auth transactions (Cohere admin expense reduction) </li><li class=\"ql-indent-1\">Drive routine process (quarterly meetings, routine phone check-ins, etc. to push practices towards achieving optimal auto approval rates, reduce pends and denials</li><li>Consultative support:</li><li class=\"ql-indent-1\">Support practices seeking to optimize their clinical protocols and/or prior auth admin workflows to better leverage the benefits of Cohere (e.g. increase auto approval rates, decrease follow-up requests for missing information, etc.)</li><li class=\"ql-indent-1\">For high-value strategic practices, disseminate relevant thought leadership</li><li class=\"ql-indent-1\">Engage practice leadership consultatively as it relates to configuration of Cohere to further practice financial goals (e.g. aligning Care Paths with any risk/procedure-based payment bundles; optimizing flow of patients to internal ancillary services, when aligned with Cohere’s client’s financial/clinical goals)</li><li class=\"ql-indent-1\">Consult on better prior auth workflows in Cohere to improve review times</li><li>Network implementation support:</li><li class=\"ql-indent-1\">Support initial implementation of new client networks</li><li class=\"ql-indent-1\">Onboard new providers/practices in mass, and periodically thereafter.</li></ul><p><br></p><p class=\"ql-align-justify\"><strong>Desired Profile:</strong></p><ul><li>Ability to constantly prioritize a large regionally assigned group of practices and independently allocate effort to the highest impact activities.</li><li>Experience working with healthcare provider data and networks.</li><li>Demonstrated expertise in data preparation and analysis using Google, Excel, Access and other Microsoft applications.</li><li>Prior experience managing mid to large scale projects.</li><li>Strong Attention to Detail</li><li>Bachelor's degree</li><li>Minimum 5 years of previous experience in the health solutions industry in a similar account management, client services, provider relations, network operations, or network development role</li><li>Must be passionate about contributing to a culture that values consistent delivery of a proactive, supportive, and partner-oriented experience to an assigned portfolio of providers/practices.</li><li>Willing and able to travel ~25-50% of the time.</li></ul>","isHybridJob":false,"isRemoteJob":true,"dateRecieved":"20211019000000","exclusiveJob":false,"isJDVerified":true,"hiringManager":"","maxExperience":"10","minExperience":"5","isOnPremiseJob":false,"onBehalfOfName":"Cohere Health","otherlocations":[],"experienceLevel":"Mid / Senior","annotationStatus":1,"maxSeniorityLevel":6,"minSeniorityLevel":3,"otherJobReference":"","sharpenedJobTitle":"Provider Success Manager","job_category_group":3,"portalLocationDisplay":"United States or Remote","educationQualification":"","expertise_coreskill_or_product":["Other"],"expertise_functional_area_hiring_team":"","job_id":"2521"}
