Physician Services Provider Operations Manager

Administrative Operations Manager

This position will provide administrative and operations management oversight for all providers employed by PruittHealth Physician Services LLC (PruittHealth Premier and PruittHealth Physicians Services). This position also provides administrative support and operational oversight for credentialing and payer enrollment for employed providers and contracted providers at skilled nursing facilities.

Key responsibilities include:

1. Point person for all office communications for PruittHealth Physician Services; receives, triages, and responds to calls, emails, voicemail, faxes, and visitors.

2. Processes department-based HR functions; includes but not limited to new hire processing, pre-employment screenings, new partner onboarding, electronic module review, and training.

3. Arranges set-up and training for provider EMR.

4. Coordinates assignment/enrollment with billing company for Physician Services.

5. Verification of required licensure and certifications; monitors licensure and certification requirements for PPS MD/NPs (GA, DEA, CPR, etc) and PruittHealth Premier providers.

6. Maintains personnel records and files per established guidelines.

7. NP/MD credentialing: coordinates provider credentialing utilizing contracted vendor.

8. Initiates credentialing for Physician Services, PruittHealth Premier providers, Hospice/Palliative Providers, and all SNF contracted providers utilizing contracted vendor.

9. Initiates 3^rd party payer credentialing/enrollment utilizing multiple platforms Madaket, PECOS, and GAMMIS/Medicaid for PruittHealth Physician Services and PruittHealth Premier as required. Initiates 3^rd party payer enrollment for Commercial Plans for Hospice/Palliative Providers using Madaket system.

10. Collaborative Agreement development and coordination, tracking and monitoring for completion for Physician Services and PruittHealth Premier Providers.

11. PPS Office Management activities; receives/responds to calls from contractors/partners/patients/families regarding PPS.

12. Collects and reports metrics from various sources (EMR/clinical, Billing/financial, customer service, etc.

13. Schedules and manages meetings for PPS activities.

14. Assists with addressing or escalating customer service issues and complaints regarding PruittHealth Physician Services or PruittHealth Premier.

15. Establishes administrative procedures and assists with continuous process improvement in operational areas.

16. Serves as a super user for electronic medical record system and reporting functionality.

17. As needed for the role; orders uniforms, computers, business cards, cell phones and/or desk phones, and eFax.

18. Administration & processing of FMLA requests.

19. Runs department HR reports utilizing PeopleSoft HRMS to verify employment status.

20. Runs license/certification report, verifies licenses and certifications online, and updates PeopleSoft accordingly.

21. Maintains health card record in PeopleSoft.

22. Liaison between partners, Partner Services, and payroll - assists in resolving any issues.

23. Receives PTO slips from managers, maintains PTO schedule, liaison with payroll department to ensure accurate deduction and accrual.

24. Explains and monitors provider CME-related conferences/travel/CME documentation.

Knowledge, skills, and abilities include:

1. Communicates well with clients, vendors, partners, visitors, and family members providing warm and friendly greeting and an approachable attitude. Answers questions when appropriate in a professional manner.

2. Demonstrates effective teaching skills.

3. Must be proficient in the use of computers (Microsoft Office, EMR, CVO and Payer enrollment platforms, etc.), phone systems, copiers, fax machines, and other various office equipment.

4. Must be able to demonstrate computer skills, including use of e-mail and Microsoft office suite.

5. Must be able to demonstrate effective written communication skills including but not limited to writing reports and correspondence.

6. Must be able to demonstrate effective verbal communication skills, including but not limited to speaking effectively to members, providers, families and staff and listening to members, providers, and families.

7. Demonstrates ability to meet deadlines, and use time effectively and efficiently.

8. Uses logical methods to solve problems with effective solutions; looks beyond the obvious for solutions.

9. Assists, as needed, in center/agency surveys (Licensure / JCAHO) and any subsequently required reports.

10. Attends and participates in continuing educational programs to keep abreast of changes in your field as well as to maintain current license/certification, as required.

11. Attends and participates in mandatory in-services.

12. Honors patients/residents' rights to fair and equitable treatment, self-determination, individuality, privacy, property, and civil rights, including the right to wage complaints.

13. Complies with corporate compliance program.

14. Reports job-related functions/tasks that involve occupational hazards.

15. Follows established safety regulations, to include fire protection & prevention, smoking regulations, infection control, etc.

16. Follows established safety procedures when performing tasks and/or working with equipment.

Minimum education required: Bachelor's Degree or its equivalent.

Minimum experience required: Three (3) years' experience in Health Care management, administrative support, or office management.

Minimum licensure/certification required by law: None.

Additional qualifications: (Preferred qualifications)

Formal education or training in Healthcare Administration desired. PAHCOM (Professional Association of Health Care Office Management) Certification; preferred. Previous experience with Electronic Medical Record environment strongly preferred. Previous experience with Provider documentation and provider credentialing preferred.

Family Makes Us Stronger. Our family, your family, one family. Committed to loving, giving, and caring. United in making a difference.

We are eager to connect with you! To get started at PruittHealth!

As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status.