Provider Liaison at QTC Management, Inc. in Philadelphia, Pennsylvania

Job Description:

Job Summary

The Provider Liaison (PL) is responsible for developing strong relationships and conducting medical reviews with new network physicians.  The PL facilitates new physician orientation traveling to national provider locations and/or  virtually training, anticipates and resolves issues to avoid downstream problems, works closely with internal and external partners to ensure physician satisfaction and contractual compliance.

Essential Duties and Responsibilities

• Responsible for developing and maintaining strong relationships with network physicians and internal business partners leading to the achievement of physician satisfaction, provider network growth and efficiency


• Facilitates both on-site and virtual physician onboarding orientations in a professional manner


• Establishes and maintains ongoing communications with assigned providers via on-site visits, routine emails and phone calls


• Anticipates and resolves potential issues to avoid downstream problems and optimize the provider experience


• Coaches providers on company best practices to help achieve ability to complete quality medical reports per contractual requirements in a timely manner


• Collaborates closely with teammates, other internal teams and external partners as needed


• Through trend analysis seeks to optimize provider experience and provides recommendations based on trends to increase provider experience and efficiency


• Responsible for thorough medical review of both general medical and specialty examination reports as needed


• Assists in the creation of training materials specific to provider specialty and line of business


• Perform other duties and responsibilities as assigned

Competencies

• Ability to build strong relationships


• Ability to work independently, take initiative and be self-motivated


• Ability to manage competing priorities with a sense of urgency


• Knowledge of  contracts and requirements


• Ability to handle difficult situations that may require critical thinking and problem solving at a moment’s notice


• Knowledge of medical terminology and ability to correlate different medical conditions


• Working knowledge of HIPAA regulations


• Ability to learn and teach proprietary software


• Strong communication and presentation skills and professionalism


• Working knowledge of medical report review

Education and/or Experience (includes certificate & licenses)

• Must be able to successfully pass National Agency Check with Inquiries (NACI) background investigation

This job description supersedes all prior job descriptions and is intended to describe the general content and essential requirements for the position listed above. It is not to be construed as an exhaustive statement of requirements, duties and responsibilities. Management reserves the right to add or change the duties of this position as required at any time.

QTC Management Inc. is a VEVRAA Federal contractor and an Equal Opportunity Employer. The company has an ongoing commitment to affirmative action and the creation of a workplace free of discrimination, harassment and retaliation. The company recruits, hires, trains, and promotes individuals in all job titles without regard to race, color, creed, religion, ancestry, national origin, age, sex, sexual orientation, people with disabilities protected under law, and  protected veteran status.