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Practice Management Consultant
Practice Management Consultant-February 2024
Wheeling
Feb 10, 2026
About Practice Management Consultant

  Under the direction of the Director, Provider Servicing, the Practice Management Consultant provides education, training and guidance for providers in the assigned provider network; drives quality discussions to increase member care, member satisfaction and provider satisfaction, responsible for performing on-site reviews of new and re-credentialed providers within their assigned territory, identify and educate providers requiring additional education (performed on-site, via conference call and/or via webinar). REQUIRED: College degree or 3-4 years' experience in a physician's office, payer agency, community agency or other health care environment. 2. Valid driver's license. 3. Previous customer service experience with exposure to claims and benefits interpretation and provider networking 4. Knowledge of medical coding. 5. Knowledge of HEDIS and Star Ratings Computer experience with Microsoft Word, Excel, Power Point and Outlook. DESIRED: Strong verbal and written communication skills with the ability to communicate (oral and written) effectively. Strong project management skills. 3. Must be able to perform presentations for small and large audiences in person and remotely. 4. Organizational skills with the ability to handle multiple tasks and/or projects at one time. 5. Customer service skills with the ability to interact professionally and effectively with providers, and staff. 6. Time management skills with the ability to prioritize and schedule daily activities for the most efficient use of time. 7. Problem resolution skills. 8. Ability to work under little supervision and act as a team member. 9. Familiar with current managed care, State and/or Federal health care programs (Medicare, Medicaid) and the insurance industry. 10. Experience in managed care, State and/or Federal health programs. 11. Certified Medical Insurance Specialist. 12. Ability to work with value based reimbursement/initiatives/projects. 13. Certification or equivalent experience in human resource management. RESPONSIBILITIES: Strong verbal and written communication skills with the ability to communicate (oral and written) effectively. Strong project management skills. 3. Must be able to perform presentations for small and large audiences in person and remotely. 4. Organizational skills with the ability to handle multiple tasks and/or projects at one time. 5. Customer service skills with the ability to interact professionally and effectively with providers, and staff. 6. Time management skills with the ability to prioritize and schedule daily activities for the most efficient use of time. 7. Problem resolution skills. 8. Ability to work under little supervision and act as a team member. 9. Familiar with current managed care, State and/or Federal health care programs (Medicare, Medicaid) and the insurance industry. 10. Experience in managed care, State and/or Federal health programs. 11. Certified Medical Insurance Specialist. 12. Ability to work with value based reimbursement/initiatives/projects. 13. Certification or equivalent experience in human resource management. Make regular visits, by phone and/or video call, to providers and act as primary resource for driving quality, operational efficiency and membership growth and retention. Travel throughout assigned geographic area, as required. BFOQ Drivers License needed for position

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