Physician Membership Support Specialist

Posted: April 14, 2021

At Great Lakes Integrated Network (GLIN), we are continuously expanding our services and remain committed to healthcare innovation, clinical transformation, and high-quality care throughout Western New York.  In order to continue to excel, we are in search of an energetic and motivated individual who is data and performance focused to support all aspects of Network Operations analytics and reporting and work collaboratively with all OPAWNY departments. 

 

The Physician Membership Support Specialist is responsible for working with the Network Operations Manager and the Great Lakes Integrated Network leadership team to manage the ongoing operations of OPA's network of physicians and the GLIN teams that support them. The Physician Membership Support Specialist will provide relevant, accurate, timely information to support GLIN and OPA operations.   This role will demonstrate business and data understanding; maintain CRM and additional support tools, draft processes, and provide training and education as needed.

 

 

Job Responsibilities:

  • Maintains and updates provider and practice accounts in Salesforce CRM to ensure data integrity
  • Creates and maintains network workflows and CRM processes to effectively manage the OPA networks
  • Maintains policies and procedures as they relate to operations and network management
  • Develops and maintains  reports using Salesforce or other data management tools
  • Works with health plan partners to ensure seamless process for transmission and receipt of membership reports, and monthly network rosters
  • Develops and assists in the development of internal and external presentations using PowerPoint
  • Creates and updates templates, dashboards, and tools in support of the OPA team
  • Assists in the development of network and quality compensation to eligible physician practices by aggregating performance data
  • Prepares and submits incentive payment requests and coordinates the distribution of incentive payments
  • Trains new and existing employees on office technologies, as necessary, on-boards new employees
  • Assists in the provider/practice enrollment process and dissemination of material
  • May perform other duties as required

Qualifications:

  • Associates Degree (Business Administration, IT Systems or related field
  • Bachelor's Degree preferred
  • Minimum of two (2) years of work experience in a customer-facing role in a Physician office, health insurance plan, or other clinical setting
  • Salesforce experience required; certified administrator preferred

 

Knowledge, skills and abilities:

  • Proficiency in Excel, Word and PowerPoint and other Microsoft Office applications
  • Ability to work well under pressure, prioritize work and clarify expectations, adapt and flex priorities as needed, and manage multiple assignments simultaneously while maintaining quality standards and meeting assigned deadlines
  • Strong organizational skills, attention to detail, works collaboratively in a team based environment
  • Ability to use independent judgment, make decisions and interpret policies and procedures to specific situations, and prioritize workload to ensure reporting timelines are met.
  • Facilitation skills - resolve issues through groups or individual interactions
  • Excellent communication skills - persuasive, encouraging, motivating, and inspiring; the ability to listen and understand; the ability to communicate the complex in simple terms
  • Establish Relationships - develop strategic relationships within and outside of direct organization
  • Knowledge of NCQA standards, regulatory compliance and value based incentive programs
  • Confidentiality- this position has access to proprietary and employee sensitive data


Optimum Physician Alliance (OPA) is a physician-led network that operates as a subsidiary of Great Lakes Integrated Network, Inc. (GLIN) – a partnership between Kaleida Health and Erie County Medical Center (ECMC). 

Please send a cover letter, resume via email to employment@opawny.com, and in the subject line please indicate the position you are applying.  Or Mail:

Optimum Physician Alliance

c/o Employment

726 Exchange Street

Suite 522

Buffalo, NY 14210

 

 

For additional information please call 1-844-769-5879 or email opainfo@opawny.com

For compliance and security related concerns, please contact compliance@opawny.com - or - 716-512-7638