Job Description
Provides oversight of network strategies and relationship development activities for assigned providers including individualized planning, training and development of providers to align with Presbyterian’s clinical quality initiatives. Will provide the framework for physician/provider performance reporting that will assist providers with objective and quantitative analysis of clinical quality performance measures.
The Network Relations Service Executive is accountable for proactively identifying issues, resolving disputes, and coordinating resolutions between the provider of service and the health plan.
Collaborates and maintains relationships with providers and staff throughout Presbyterian to ensure an exceptional provider experience. Accountable for resolving complex problems and acting as a liaison between the provider and the health plan. Provides education on quality initiatives, managed care, capitation, products, policies/procedures, reimbursement issues, referral/authorization process, etc.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve as a locally owned, not-for-profit healthcare system.