Kelsey-Seybold Clinic, a Houston tradition in patient-centered care, is a multispecialty clinic with 25+ locations and is comprised of more than 500 physicians providing primary and specialty care in a collaborative manner.
With more than 55 different clinical and non-clinical specialties, you can design a career path at Kelsey-Seybold Clinic that allows you to grow your future in a completely new direction.
The Manager of Network Integration is responsible for oversight of the Sr. Provider Relations Liaison team and their efforts towards establishing and maintaining strong positive business relationships with current and potential Kelsey-Seybold and KelseyCare Advantage affiliate and employed providers to ensure stable and geographically disperse networks for the Kelsey-Seybold commercial and Medicare Advantage health plans and KS Plan Administrators’ health plan products. Responsibilities include developing educational instruction and ensuring support to physicians and their staff. The Senior Provider Relations Liaison will be the main point of contact for the respective providers and will routinely visit physician’s offices for issues concerning the achievement of provider satisfaction, medical cost targets, network growth, and/or efficiency targets. This role includes responsibility for the education of the physicians and office staff on health plan products and benefits, policy and procedure for multiple managed care plans, assistance with claims payments, and other duties as assigned. Travel requirements – local and extensive.
Consider Kelsey-Seybold Clinic
If you want a satisfying career and a rich, rewarding personal life, don’t choose between them.
Achieve them both at Kelsey-Seybold Clinic.
For more information, please contact Mario Lynch at firstname.lastname@example.org
Kelsey-Seybold Clinic is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, or protected veteran status. Kelsey-Seybold is a VEVRAA Federal Contractor and desires priority referrals of protected veterans.
Bachelor’s Degree (1-year experience equivalent to 1 year of college)
5+ years contract negotiation experience at a health plan or medical group.
5+ years experience in provider relations or network management with a demonstrated ability to perform network development and/or provider relations.
Experience with developing provider and/or facility networks.
Must possess knowledge of claims processing, managed care plan benefits, and utilization management policies and procedures.
Must own or lease a working vehicle and be able to travel daily within the Greater Houston area.
Demonstrated knowledge of CPT and ICD-10 coding and prior experience with reimbursement methodologies
Proficient with Microsoft Word and Excel
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
Graduate degree in Business or Healthcare Administration.
Demonstrated negotiation skills and ability to interpret provider contracts and regulatory contracts.
3+ years of experience in Medicare/Commercial products
5+ years experience in applicable healthcare administrative operations
Internal Number: 24980
About Kelsey-Seybold Clinic
Kelsey-Seybold Clinic is Houston's premier multispecialty group practice, founded in 1949 by Dr. Mavis Kelsey in Houston's famous Texas Medical Center. More than 500 physicians and allied health professionals practice at 25+ locations and an accredited Sleep Center in the Greater Houston area. Medical services offered by Kelsey-Seybold include medical care in 55 medical specialties including primary care and specialty care, outpatient surgery centers, an accredited Sleep Center, a Radiation Therapy Center, laboratory services, advanced radiology services and other diagnostic services, 15 on-site Kelsey pharmacies, and a secure web portal for patients to communicate with their Kelsey-Seybold doctors, get test results and schedule appointments.
Kelsey-Seybold has been recognized by the National Committee for Quality Assurance (NCQA) as the nation’s first accredited Accountable Care Organization and a Level 3 (highest) Patient-Centered Medical Home. Kelsey-Seybold has many physicians in the Greater Houston area certified for excellence in diabetes, heart and stroke care by the NCQA. In addition to these recognitions, Kelsey-Seybold is home to a nationally accredited Breast Diagnostic Center, Endoscopy Center, Infusion Center, and Cancer Center.