Provider Resources, Inc. ยท 22 hours ago
Stakeholder Engagement Manager No Surprises Act
Pennsylvania, United States
Full-time
Remote
Mid Level
$120K/yr - $180K/yr
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No H1B
Security Clearance Required
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Responsibilities
Understand and represent PRITM's mission, vision, and values to all internal and external customers
Interact with government and private sector clients, partners, and PRITM staff in a professional and accountable manner, and as a representative of PRITM management
Engage clients in appropriate communication that manages client expectations and builds a collaborative relationship with the client
Proactively manages and coordinates activities to ensure timeliness of deliverables to exceed contractual obligations
Interact with project team members to successfully fulfill contract obligations with the highest quality and in a timely manner meeting PRITM's ISO requirements
Instills integrity throughout the organization via active participation in ISO requirements including but not limited to timely submission of Corrective Action Plans for all matters in which either PRITM standards and/or corporate contract standards have not been met. Communicating outcomes to team members to ensure a positive, open, environment which mitigates risk and achieves a culture of Continuous Quality Improvement
Contributes to business development efforts for new sales and marketing to promote the business through professional communications, sound decisions and by exceeding all contract timeframes and deliverable requirements
Proven skill and experience in excellent oral and written communication spanning executives to the public
Reviews and applies federal and state law, rules, guidance and operational processes applicable to the IDRE program and No Surprises Act
Must have experience working in health care industry
Experience in analyzing and applying federal and state law, rules, guidance and program policies applicable to health care and dispute resolution
Serves as lead individual for stakeholder communications with ability to diffuse confrontational interactions using data and facts
Oversees the Engagement Team to ensure that team members utilize critical thinking skills, apply IDRE program policies, state and federal laws and regulatory guidance to adjudicate disputes, complete all case related documentation, and send appropriate email notification per the established workflow
Oversees completion of the IDRE Correspondence log, including daily analysis of the information, and submits the log to Senior Management
Identifies patterns and trends in correspondence data, and works collaboratively with Senior Management to implement corrective action plans and evaluate program performance
Utilizes legal knowledge and project resources for research and reference verification
Demonstrated skill and experience in managing a large workload with varying deliverable dates
Flexible to meet contract performance metrics
Participate in interdisciplinary collaboration with PRITM staff, recognized teaming partners, and/or subcontractors
Demonstrated skill and experience in management and oversight to ensure submission of timely, accurate deliverables
Demonstrated experience and skills in excellent customer service
Interact with government and private sector clients, partners, and PRITM staff in a professional and accountable manner, and as a representative of PRITM
Perform other duties as requested
Qualification
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Required
Juris Doctorate degree
Knowledge of and experience in arbitration, dispute resolution, federal and state law, regulatory guidance and application of policies
Able to communicate in a clear manner when explaining the relationship of applicable laws, guidance and/or regulation to specific disputes throughout the IDRE program and with stakeholders
Excellent written and verbal communication skills
Ability to deal with difficult stakeholders and diffuse confrontational situations
Ability to lead a team to investigate and resolve issues raised
Ability to work collaboratively to meet program goals
Has a thorough understanding of the Federal IDR process, regulations related to the Federal IDR program
Applies Federal IDR regulations and policies, and PRITM policies, when evaluating Disputes and the overall PRITM IDR program
Strong analytical and problem-solving skills with the ability to communicate solutions within the program and to stakeholders
Reliable and trustworthy; Integrity is required
Excellent organizational skills and ability to pay attention to detail
Ability to contribute to and work effectively within a team environment
Ability to interface with management and contract staff personnel
Proficient user of Microsoft office suite such as Outlook, Access, Excel and Word
Ability to be discrete and maintain confidentiality
Must have no adverse actions pending or taken against him/her by any State or Federal licensing board or program
Must have no conflict of interest (COI) as defined in 1154(b)(1) of the Social Security Act (SSA)
Ability to obtain and maintain U.S. Government Security Clearance
Preferred
Preference will be given to those individuals where their primary residency is located in a qualified HUBZone
Company
Provider Resources, Inc.
Provider Resources, Inc.
Founded in 2003
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Shawn Keough-Hartz
CEO/President
William McBee, CFE-retired - LPI
Executive Vice President, Chief Compliance Officer
Company data provided by crunchbase
