IPA Administrator in Orange at Prospect Medical Systems

Date Posted: 6/22/2020

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    600 City Parkway West
    Orange
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    6/22/2020
  • Job ID:
    14708

Job Description



IPA Administrator

We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.

The IPA Administrator for Prospect Orange County CA IPAs will engage with MSO leadership, IPA physicians and stakeholders to ensure quality, membership growth and financial success is achieved. Responsible for working with the provider contracting department to negotiate and secure exclusive PCP contracts, identifying and drive business acquisition or management opportunities, identify opportunities to drive  membership growth with current physicians and recruitment of new physicians.  Key responsibilities include ensuring performance results with assigned PCP’s is aligned with revenue and company-wide initiatives, proactively resolve operational issues, and effectively communicating directly with physicians, office staff and internal departments. Work with the business development team to administer effective marketing efforts to successfully achieve membership growth targets.



Job Responsibilities/Duties

  • Work closely with medical directors and Performance Department to monitor utilization of health care services, RAF improvement and overall quality of care. 
  • Identify opportunities to achieve membership growth by developing and capitalizing on relationships with physicians and pursuing business opportunities to support companywide revenue goals.
  • Conduct routine visits to all providers as outlined in department policies: 1) to ensure performance compliance with revenue driven initiatives, 2) to engage in open face to face dialogue with physicians to communicate/educate important issues and updates, 3) ensure effective problem resolution, and 3) facilitate communication between the Provider Relations Department and Provider.
  • Maintain positive business relationships to ensure retention of existing providers, therefore, decreasing the potential membership loss due to provider terminations.
  • Comply with production reporting requirements as stated in Department Policies and Procedures by required time frame.
  • Coordinate successful implementation of any membership transfers to ensure members remain with the company, to include developing transition plans with Member Relations to achieve the greatest retention of members, coordinating meet and greet functions with receiving physician office, developing member letters for receiving physician to send out, etc.
  • Analyze global performance of entire network across all departmental and company objectives and identify non complaint providers.


Qualifications

Minimum Education: Four (4) year college degree preferred.

Minimum Experience: Minimum of five (5) years of HMO/IPA experience in Network Management or Contracting. Working knowledge of IDX. IPA Operations experience strongly recommended. Previous supervisory experience preferred. Must have knowledge of Asian community.

Req. Certification/Licensure: None.



Employee Value Proposition

Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals you will receive:

  • Company 401K
  • Medical, dental, vision insurance
  • Paid time-off
  • Life insurance

Prospect Medical Systems has a zero-tolerance policy regarding the use of drugs and alcohol.  Our Company is committed to maintaining a productive, drug free workplace that keeps employees and patients safe from harm.  For this reason, we require applicants to pass a screening for drug use as a condition of employment.  This includes: alcohol, marijuana, cocaine, opiates and methamphetamines.



How to Apply

To apply for this role, or search our other openings, please visit http://pmh.com/careers/ and click on a location to begin your journey to a new career with us!

We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.

EEOC is the Law: https://www1.eeoc.gov/employers/poster.cfm



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