Senior Provider Relations Representative

North American Medical Management - Illinois, Inc. is a national industry leader in the management of healthcare delivery systems. Currently we are seeking a Supervisor, Referral Coordinators to work in our Medical Management Department as described below.


The P/R Representative will be responsible for support in managing the results both financially and operationally of the IPA/PHO as assigned, accessing direction as needed from the assigned Executive Director or Associate Administrator.



Responsibilities & Functions: Board/QM Meetings Preparation of agendas



Minutes

Attending meetings

Preparing ?To Do? List

Follow-up ?To Do? List



Conducting orientations/re-orientations



Monitoring of encounter data and acting upon issues



Update offices on policies & procedures



Resolving member service issues/claim inquiries



Attending Open Houses



Updating network matrices & directories



Verifying and distribution of Capitation checks/referral forms



Determining/communicating/resolving office staff concerns



Identifying ?trends? in physician activity rather than reacting to occurrences



Physician contracting/rate negotiations/follow-up



Conducting financial meetings with physicians



Assist in contracting/negotiation of payor contracts



Other duties as assigned by management











Requirements: Two years of managed care experience.



Four years of administrative experience supporting mid to high level executives in an office environment.



Must have good communication skills,



ability to work within team environment,



must provide own transportation.





We offer a competitive salary & comprehensive benefits package including health, dental, vision, 401(k), Life, STD, LTD, and more!



Interested and qualified applicants please e-mail or fax resume with cover letter and salary history to:



Human Resources

Fax# 708-432-0165

hr@namm-il.com





NAMM is proud to be an equal opportunity employer.