Cedars-Sinai Physician and Network Liaison - Contracting in Los Angeles, California
The Physician and Network Liaison serves as a liaison between Cedars-Sinai Medical Network (CSMN) and its contracted and non-contracted physicians, internal departments as well as managing various projects for carrying out program strategies that are in-line with the overall organizational goals to provide high quality, clinically efficient care while maintaining a robust and integrated physician/ancillary vendor network. Will spend a significant portion of time "in the field (virtually)". Will create good relationships with physicians, their staff, and internal customers (e.g. Physician Billing Services, Patient Provider Services, Network Management, MCO, Foundation Ops Managers, etc.). Provide timely responses to Contracting and Network questions, ensure compliance with CSMN policy and procedures, elevate excellence in the delivery of care, support the Contracting and Network Management initiatives including other Accountable Care Organization (ACO) programs.
Job Duties and Responsibilities:
Serves as liaison and establishes relationships with physicians contracted and non-contracted with CSMN and their key staff as well as internal departments. Ensures that their offices are well-educated on CSMN policies and procedures and kept up-to-date with any health plan, organizational and industry changes. Coordinates with Network Management to conduct site visits with contracted physicians and their staff and soliciting feedback on ways to further engage physicians in coordinating care for their patients.
Responsible for negotiating and finalizing network contracted based upon network analysis and established parameters as advised by Contracting Manager and/or Executive Director.
Manage contracting efforts through entire procurement process. Ensure contracts are administered and implemented accurately.
Work with internal departments to negotiate letter of Agreements with non-contracted physicians and ancillary provider.
Prepare comprehensive network analysis in order to identify gaps of needed providers
Help recruit new physicians or providers, perform contract negotiations, train employees on reimbursement procedures and provide other education and training opportunities to improve the efficiency of reimbursements and other integral aspects of health care provisions.
Works closely with all internal departments, including EIS, to provide timely responses to all physician and staff questions and concerns. Evaluates trends and makes recommendations to CSMN management on policy or procedural changes to improve systems or services.
Responsible for the coordination, receipt, and review and processing of all provider contracts, credentialing, and provider correspondence to ensure the department has obtained proper signatures and documentation to effectively process newly recruited or existing providers.
Works closely with physicians and their staff to improve patient satisfaction and access to primary care and specialty care. Actively assesses practice operations, systems, and staffing to make recommendations for improvement and to see opportunities for CSMN to collaborate with physicians on operational improvement or provide additional support to offices. Deploys services as they become available to network physicians.
Coordinates physician and staff “onboarding” and “offboarding.” Conducts orientation sessions and ongoing in-services for CSMN physicians and their staff. Recommends and coordinates specialized training to support member needs.
Works with all department heads to ensure all Population Health strategies are being promoted including supporting an all quality initiatives and Patient Engagement goals of the organization. Implements CSMN communication strategies to ensure distribution and understanding of key messages. Encourages physician and staff participation in all CSMN initiatives, including the coordination and conducting of quarterly physicians and staff meetings.
Evaluates enrollment trends and patient and physician satisfaction surveys to find opportunities to improve service. Collaborates with Quality Management to identify trends and resources to respond to individual issues.
Markets existing and new CSMN programs and services. Represents all Cedars-Sinai Medical Deliver Network departments in their efforts to enhance services and develop new business models for CSMN.
Works with the department Executive Director to ensure all CSMN initiatives are being supported, including the support of any physician governance groups’ Task Force. The Physician and Network Liaison will conduct himself/herself as the Administrative Lead when supporting these Task Forces.
Analyzes program data and identifies overall quality and efficiency, specialty cost and utilization trends to present to senior leadership. Makes recommendations on areas to focus resources and attention.
High school diploma or GED required. Bachelor's degree in Health Care Management, Public Health Management preferred.
Three (3) years of experience in Physician practice management required if no BA degree in Health Care Management or Public Health Management.
Cedars-Sinai is an EEO employer. Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law.