Provider Education & Relations Coordinator

Company: Kepro
Location: Auburn
Posted on: June 7, 2021

Job Description:

Kepro is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting. Kepro is seeking resumes for a highly experienced professional.Provider Education & Relations CoordinatorSummary DescriptionUnder the direction of the Program Manager of the Alabama Utilization Management Program, this position provides overall leadership for Provider & Recipient Education and other stakeholder relations for a contract with the Alabama Medicaid Agency, serving Alabama Medicaid members.Accountabilities Assist recipient with prior authorization issues, contact providers to provide form and prior authorization policy, and coordinate with provider to ensure recipient receive items and services covered by Medicaid. Assist providers (to include, but not limited to Long Term Care/institutional facilities, physician offices, DME provider, etc) in coordination. Make/receive phone calls from both providers and recipients. Responsible for planning, developing, facilitating and evaluating outreach and education programs for providers and stakeholders, including on-demand webcasts. Conducts education needs assessments and designs curriculum appropriate to the service needs. Cross trains and perform duties of other contracts within Kepro to provide a flexible workforce to meet client/customer needs. The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.Qualifications Bachelor's Degree preferred, preferably in a Human Service field. LPN, RN, or social worker strongly preferred with unrestricted license with respective professional board (if applicable). Must reside in Alabama. Knowledge, Skills, Abilities Knowledge of InterQual criteria strongly preferred. Knowledge of current NCQA/URAC standards strongly preferred. Medical record abstracting skills required. Knowledge of the organization of medical records, medical terminology, and disease process required. Knowledge of curriculum development, course planning and effective uses of technological education tools and audio/visual equipment required. Exceptional organization, customer service, communication skills, including writing and facilitation, and a strong team ethic is a must. Ability to manage multiple and changing priorities with sometimes conflicting deadlines. Must be proficient in MS Office and able to navigate through multiple screens. Ability to become proficient in additional educational software and to use the Internet as a research tool also helpful. Ability to maintain confidentially standards and HIPAA compliance when working with medical providers and other stakeholders. Sense of urgency to meet deadlines. Experience 2-3 years' experience in a healthcare environment, preferably in hospital, outpatient, managed care/utilization management, Care Management or LTC environment. Minimum 5 years training and expertise in preparing and delivering informational and instructional programs for adults, required. Experience with State Medicaid or other state government programs preferred. Mental and Physical Requirements The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.Kepro offers challenging careers, excellent benefits and opportunities for advancement. For consideration, please submit resume and cover letter with salary requirements. Only those candidates identified for an interview will be contacted. No Phone Calls Please. Visit our website at for more information on the Kepro Family of Companies. EOE AA M/F/Vet/DisabilityKepro is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Keywords: Kepro, Auburn , Provider Education & Relations Coordinator, Other , Auburn, Alabama