Director, Kelsey Community Network

Kelsey Seybold Clinic Pearland, TX
Overview

Director, Kelsey Community Network

Location: Pearland Administrative Office

Department: Mgd Care Communications

Job Type: Full Time

COMPANY PROFILE

Kelsey-Seybold Clinic. Your Doctors for Life.

Since 1949, Kelsey-Seybold Clinic has served its patients with one goal in mind – combine the expertise of physicians in a variety of medical specialties, with the close personal care of a family doctor. Kelsey-Seybold is Houston's largest community-based physician group, caring for more than 400,000 patients. With 19 clinic locations, we are growing to meet the health care needs of our diverse patient population. Our mission is to provide our team members with exceptional opportunities for professional and personal growth.

JOB SUMMARY

This Director's responsibilities include participation as a member of the Senior leadership team to plan, design and execute the Kelsey Community Network (KCN) primary care affiliation expansion strategy. This position will work with Medical and Executive leadership to achieve the primary care physician growth and geographic access goals of the Kelsey-Seybold Medical Group and will be responsible for achieving annual network growth targets by successfully onboarding new KCN affiliate physicians and their office staff. By working in collaboration with the Medical Director and Director of Sales, this position will lead the effort to develop and implement effective training and orientation programs to support the KCN affiliate practices and provide day-to-day leadership of the Provider Relations Liaison team. Upon request, the Director will prepare and make formal presentations to Executive and Medical Leadership. The Director will serve as the Kelsey Community Network subject matter expert and as a resource for all levels of KS management. This Director will design programs and implement strategies that will build and nurture positive relationships between the KCN, Kelsey-Seybold Medical Group physicians, Kelsey-Seybold Affiliate providers (physicians, hospitals, ancillary, etc.) health plan partners and Kelsey-Seybold administrative teams. Travel requirements – local and extensive.

EDUCATION REQUIREMENTS & EXPERIENCE REQUIREMENTS

(A = basics; B = preferred)

Education

A.

Bachelor's Degree in healthcare administration or related degree.

MBA or MHA

Experience

A.

7-10 years of management experience with a health plan, medical group, IPA, ACO or MSO with demonstrated contract negotiation, network development and provider relations experience.

3+ years of management experience that includes responsibility for budgeting, strategic planning and contract management.

Experience with developing provider and/or facility networks. Must possess a knowledge of reimbursement/revenue cycle, value based/risk sharing contracts, managed care plan benefits and utilization management policies and procedures.

Demonstrated expert negotiation skills and ability to interpret provider contracts.

Licenses

A.

Valid Texas Driver's License and ability to travel. Must own or lease a working, reliable vehicle and be able to travel daily within the Greater Houston area.

Special Skills

A.

* Demonstrated knowledge of CPT and ICD-10 coding and prior experience with reimbursement methodologies

* Demonstrated ability to manage a variety of complex projects and resolve complex issues effectivel

* Supervisory experience at a health plan, medical group or managed care organization. Previous experience in a provider relations environment.

Other

A.

* Proficient with Microsoft Word and Excel and PowerPoin

* Exceptional presentation, written and verbal communication skills.

* Excellent organization and planning skills

* Excellent analytical and problem-solving skills; ability to communicate effectively in writing and verbally

* Ability to work in a fast-paced environment; demonstrated ability to perform multiple concurrent tasks with minimal supervision and meet deadlines

* Demonstrated public speaking and presentation skills

WORKING ENVIRONMENT

Office