Provider Workflow Support Specialist

What you can expect! 

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

The Provider Workflow Support Specialist works as a care facilitator who works closely with Provider Relations Management Team to develop and implement improved/new workflows and share quality improvement curriculum, including best practices, clear expectations, and training and dissemination materials, for the eConsult initiative. This Team Member also works closely with Provider teams to implement eConsult workflows and integrate new processes into both primary care and specialty care clinics, coordinating with Provider Services, UM, and IT staff at IEHP on related initiatives as needed to ensure clear, consistent, and achievable goals are set and met. The Provider Workflow Support Specialist will also support the Provider Relations Department with other duties as assigned.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.

• CalPERS retirement
• 457(b) option with a contribution match
• Generous paid time off- vacation, holidays, sick
• State of the art fitness center on-site
• Medical Insurance with Dental and Vision
• Paid life insurance for employees with additional options
• Short-term, and long-term disability options
• Pet care insurance
• Flexible Spending Account – Health Care/Childcare
• Wellness programs that promote a healthy work-life balance
• Career advancement opportunities and professional development
• Competitive salary with annual merit increase
• Team bonus opportunities

1. Provide hands on support to Provider offices and clinics to implement and incorporate CareNow
2. Providing support for current Providers and office staff with the CareNow system, assisting IEHP Team Members or Providers with issues and escalating to the appropriate Management
3. Develop and manage strong relationships with Providers, responding quickly to inquiries and concerns and resolving them effectively, understanding Provider practices and utilization of CareNow
4. Be a subject matter expert in the framework, workflow, and daily operations of the CareNow program, including system requirements, troubleshooting, reporting and data analytics
5. Work closely with Provider Operations, Utilization Management and Provider Service Representatives to assist with any issue a Provider or office staff is experiencing with the CareNow process
6. Document and archive all interactions with Providers and office staff and communicate trends to IEHP Management
7. Engage facility teams to identify and implement process improvement and workflow redesign solutions to overcome challenges and achieve improvements in patient access to specialty care expertise through the CareNow Platform
8. Conduct assessments of referral and scheduling workflows and processes, including standard work, template management policies, staffing structures, etc
9. Provide guidance and develop supportive relationships to enhance facility engagement with CareNow and referral management
10. Work closely with both internal and external CareNow team members to identify opportunities for improvement and follow through with clinic staff to implement additional training as needed
11. Work closely with Provider teams to promote, advise on, and conduct in-service trainings, grand rounds, workshops, and other activities as needed to engage providers and staff in the CareNow initiative
12. Communicate effectively as a liaison to Providers as they learn and master CareNow workflow. 
13. Work with other WFEs to help with orientation, capture workflows, create documents and communicate with clinics and their staff
14. Capture any meeting minutes with questions and or concerns that come up in the meetings 
15. Assist the PSRs by monitoring Providers through utilization reports, QA reports, Provider Report Cards, quality data and cases presented through IEHP’s Customer Relations Management Tool (HSP) to provide training to improve Provider performance, close care gaps and improve access to care
16. Assist the PSRs by supporting the investigation and resolution of Provider grievances
17. Promote electronic submission capabilities including the timely and complete submission of encounter data, claims and utilization data related to IEHP’s quality metrics, namely HEDIS
18. Supports the Provider Relations Team with any activities that involve the improvement of outcomes with Providers and Members
19. Develop and participate in training with all IEHP systems including HSP, Medhok and CareNow system
20. Any other duties as required to ensure Health Plan operations are successful
21. Utilize Critical Thinking skills when working with internal and external stakeholders
22. Embrace IEHP Mission, Vision and Values

Education & Experience

• Two (2) years of experience in Provider office and referral and scheduling workflow and processes, and/or Health Plan operations experience
• Bachelor’s degree from an accredited institution required

Key Qualifications

• Must have a valid California Driver's license and valid automobile insurance. Must qualify and maintain driving record to drive company vehicles based on IEHP insurance standards of no more than three (3) points
• Customer service, sales and customer retention preferred
• Formal training by a vendor or certified user of a Practice Management system or Electronic Medical Records system preferred
• Basic understanding of eConsult and referral management. Provider office and IEHP referral and scheduling workflow and processes

Start your journey towards a thriving future with IEHP and apply TODAY!

This position is on a hybrid work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho Cucamonga, CA)