Health Plan Liaison (Hybrid)

***While this role is hybrid remote, the candidate MUST live in the Tampa/surrounding area as occasional travel to our corporate office is required.***

Our mission is Better Health. Our passion is helping others.

What’s Your Why?

• Are you ready to join a growing team that shares your mission?
• Are you looking for a career opportunity that will help you grow personally and professionally?
• Do you have a passion for helping others achieve Better Health?

Why Join Our Team: At Votion, it’s our commitment, our passion, and our culture that sets us apart. Our Team Members make a difference each and every day! We don’t just talk the talk - we believe in it and live by it. Our core value is always to deliver 5-star service. And by doing so, we successfully achieve our mission of Better Health. We support our providers with all the necessary tools and resources they need to deliver the care all patients deserve. Be part of a team that is rebuilding sick care into Better Health Care. We take great care of our team, patients, providers, and affiliates because together, we can achieve: Better Care. Better Outcomes. Better Health.

Responsibilities

The Health Plan Liaison will directly support the Votion Team. They will be expected to perform within the following scope, as well as other assigned duties and activities that aid and leverage our Team function. Responsibilities include and are not limited to:

• Create and update/maintain Health Plan Resources documents and quick reference guides
• Confirm that requests are received by the Credentialing Team and submitted to the Health Plans
• Create panel status changes tracker and distribute to Provider Operations and VIPcare leadership teams to review and make changes; follow up until completed
• Action items should be shared with all attendees within 1 business day after the meeting
• Participate in the review of the Provider Directory to confirm accuracy prior to printing
• Disseminate materials to all applicable internal and external parties
• Communication with internal teams and Health Plan partners is clear and concise throughout the expansion process
• Ensure health plan open task spreadsheets are complete and up to date with current statuses on a weekly basis by Tuesday of each week
• Follow up credentialing paperwork submissions weekly to ensure deadlines are met
• Check Google form submissions to ensure accuracy
• Follow up weekly until the Health Plan representative confirms the termination was processed and notification letters were sent to the patients
• Introduce key Health Plan stakeholders to the Physician Partners team
• Obtain credentialing documents from the Health Plan
• Create an accurate contact list for distribution to the Physician Partners team
• Must arrive at the meeting on time
• Create meeting action items and share them with attendees after the meeting
• If Health Plan outreach is needed, email the applicable Health Plan Representative and follow up until resolution
• Create a list of targeted PCP offices to participate in the expansion
• Solicit agenda items from all Votion department leads
• Demonstrate ability to manage time and organize meetings effectively
• Identify the need for new resources to be created based on requests received from internal teams
• Confirm patients were transferred to the appropriate recipient PCP after the termination effective date has passed within 2 business days of the patient roster being updated
• All action items are completed by the due dates set forth by the Health Plan and Manager of Core Operations
• Create quick reference guides compiling information from various health plans into a single resource to be used by internal and external parties
• Work closely with Health Plan representatives to complete all action items throughout the process
• Terminations:
• Manage intake for PCP office-specific, health plan-related inquiries via the Google form submission process and update and maintain status columns until resolution
• Send open health plan task spreadsheets to the Health Plans weekly or at the frequency agreed upon with the specific health plan
• Ensure the accuracy of the PCP office target list and action plan throughout the expansion process
• Obtain onboarding orientation packet from Health Plan to be distributed to the Provider Operations team
• Update each quick reference guide at least once per calendar year or as changes occur
• Create the meeting agenda and/or presentation and share it with attendees prior to the meeting
• Research each issue to determine if it can be resolved internally or whether Health Plan outreach is needed. If the issue can be resolved internally, educate the team members on the appropriate process
• Ensure documents are 100% accurate and free of grammatical and formatting errors
• Update internal trackers and systems immediately to reflect changes
• All communication prior to, during, and after each JOC meeting is clear, concise, and free of errors
• Other designated administrative, clerical, or operational tasks as assigned to leverage Votion's goals
• Support Health Plan Joint Operations Committees
• Maintain a great attitude and has the ability to build and foster positive relationships with PCP offices, Health Plan partners, and internal teams
• Attend and participate in Core Operations team meetings, 1:1 meetings with the Manager of Core Operations, and interdepartmental market meetings as required
• Communicate with the Health Plan representative at least weekly throughout the expansion process to confirm all action items are completed on time
• Cultivate strong and positive relationships with Health Plan partners
• Coordinate with Health Plan representatives to schedule meetings on a monthly or quarterly basis
• Once responses are received from the health plan, update the status and take action as needed
• Lead the meeting and introduce attendees if applicable
• Demonstrate discernment and respond within the same business day for urgent requests (inquire with Manager / Director to define as needed) and within 2 business days for non-urgent requests
• Once the need for a new quick reference guide is determined by Physician Partners management, the new document should be completed within by the due date specified by the Manager of Core Operations
• Utilize Google Calendar effectively
• Follow up on action items discussed during the meeting
• Create Action / Project plans for onboarding new Health Plans / Markets
• Act as the point of contact to resolve PCP office-specific issues
• Confirm that Credentialing Team follows up until the changes are confirmed by the Health Plan
• Support Credentialing team with Provider Office Maintenance requests (Age Band, Cap Rate / Payment Methodology Changes, Credentialing, Office Demographic Changes, Panel Status Changes, Service Area Expansions, Terminations)
• Work closely with Provider Operations to ensure PCP Offices are targeted and informed appropriately regarding Health Plan expansions
• Support the annual AEP process
• Communicate updates and timelines to all internal department leads
• Communicate updates same day to internal teams affected by the termination of PCP
• Review the open task list during meetings with the health plans as applicable
• Team members should follow up with applicable parties on at least a weekly basis until the issue is resolved
• Must introduce all Physician Partners attendees with the correct name and title
• Demonstrate knowledge of Health Plan specific policies, procedures, and resources
• Demonstrate ability to research, investigate and actively resolve simple to complex issues; escalate as necessary to Manager and/or Director of Core Operations; provide guidance on available resources prior to forwarding the communication
• For Health Plan onboarding
• Agendas must be shared with all attendees at least 7 days prior to the meeting

Key Attributes:

• Has a contagious and positive work ethic, inspires others, and models the behaviors of our core values and guiding principles
• An effective team player who contributes valuable ideas and feedback and can be counted on to meet commitments.
• Pursues activities with focus and drive, defines work in terms of success, and can be counted on to complete goals.
• Is able to work within our Better Health environment by facing tasks and challenges with energy and passion.
• Demonstrated ability to handle data with confidentiality

Additional Education & Skills Preferred:

• Ability to work in a shifting and fast-paced environment
• Excellent organizational, time-management, and multi-tasking skills with strong attention to detail
• Must be able to work professionally with confidential information
• STRONG reasoning and critical thinking are required.
• Ability to work cross-functionally with multiple teams
• Proven ability to work with Google Suite software or equivalent (MS Excel and MS Powerpoint)
• At least 3 years of experience in a healthcare-related environment
• Ability to shift focus, multi-task, and prioritize in a rapidly changing environment.
• MUST be results oriented with a focus on quality execution and delivery.
• Bachelor’s degree in Healthcare Administration or related field preferred
• Excellent written and verbal communication skills.
• Ability to work independently with minimal supervision
• Demonstrated resourcefulness, initiative, and results-oriented capabilities

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