Job description
About Hopscotch Health
At Hopscotch Health, we believe great healthcare should be accessible to all people across all communities. We provide advanced primary care services in our clinics, and across care settings, delivering robust care in our end-to-end model.
We are on a mission to transform healthcare for rural communities across the country, one at a time, through advanced primary care. Our goal is to transform the patient and provider experience, strengthen communities, and enable better healthcare, especially for those who need it most.
As an innovative and rapidly growing company, we are looking for exceptional team members who share our passion and values. If you are mission-driven, skilled yet humble and looking to make a lasting impact in healthcare, we'd like to meet you.
About the Role
Hopscotch is seeking a results-oriented, team-focused, and mission-driven professional to manage and evaluate the company's contractual relationships with payers. You will be responsible for tracking information related to payer contracts, monitoring contract policy changes, overseeing credentialing, and developing and growing relationships with payers, physician practices, and operational leadership.
Our ideal candidate will bring skill, tenacity, and organizational skills to manage a complex suite of payer contracts.
This position is open to remote-based candidates located in Central or Eastern timezones.
What You'll Do
Specific responsibilities for this role will include, but are not limited to:
- Maintain and evaluate contractual relationships for physician practices with payers, including ACO and MSO participation
- Oversee credentialing and enrollment of all billable disciplines within Hopscotch Health
- Provide direct leadership and management for credentialing team member(s)
- Manage third party contracts for licensing, credentialing and enrollment
- Responsible for daily/weekly/monthly reporting requirements to the business
- Acts as primary liaison between payers, internal team, and market
- Manage communication and transition to market operations, provider candidate and Human Resources/People Team
- Responsible for re-credentialing timelines and tracking mechanisms; notifying providers and clinical leadership
- Creates effective training programs, policies, and processes to ensure best practice adoption
- Obtain, track, and document original agreements between physician practices and payers in a central repository tool, providing updated status reports to leadership
- Map practice participation to Hopscotch Health payer contracts, determine gaps, and develop recommendations to close gaps
- Be responsible for providing payers/MSOs appropriate termination notices, change of ownership status and any other required communication according to contract terms
- Ensure accepted payer types are included for open panels for each payer/MSO entity and notify payers of any panel closures
- Update payers on new providers added or departing from the practices, according to the contract terms
- Monitor policy changes from payers, identify impact to Hopscotch Health and implement strategy for updated practices within the organization to comply
- Manage process and timing to existing and new providers into Value Based Care arrangements within the organization
- Collaborate with Market President, Outreach Leader, Broker Leader and Patient Relations Managers to communicate payer contracts, contract changes, and ensure alignment with payer benefits for effective patient engagement
- Serve as an expert on payer administrative policies and procedures
About You
You would be a great fit for this position if you have 2-5 years of experience in a payer and/or health services provider group and with administering managed care contracts, and you are:
- Skilled at building strong working relationships across providers, payers, and operational leaders
- Knowledgeable about health plan network operations
- Highly-organized and able to keep track of the status of multiple projects at once
- Comfortable with ambiguity and bring a structured, proactive approach to get things done and execute
- Results-driven and able to efficiently allocate time/resources across multiple priorities
From a cultural perspective, you are:
- Agile, yet thoughtful and can work effectively in a fast-paced, ever-changing environment
- Constantly seeking ways to simplify and improve how things are done, bringing a positive attitude to challenges
- Accountable, holding yourself and others to a high standard and seek to support and develop others
- Willing to roll up your sleeves to support the work required and collaborate effectively with people of all backgrounds
- Concise and articulate, drive towards clarity and deliver on your commitments
- Collaborative, assuming positive intentions
- Customer-focused, with a passion for serving patients and providers who make healthcare possible
Hopscotch Health is committed to serving our providers and teams who serve our patients and our communities. We offer competitive compensation and benefits for our employees and a collaborative, positive culture committed to patient care.
At Hopscotch Health, we embrace diversity, invest in a culture of inclusion and positivity and encourage all to apply to join our team. You will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
jjbodyshop.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, jjbodyshop.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, jjbodyshop.com is the ideal place to find your next job.