Professional Medical Services Administrator

Aquí es donde salvas y sostienes vidas

En Baxter, estamos profundamente conectados por nuestra misión. No importa tu rol en Baxter, tu trabajo tiene un impacto positivo en la gente alrededor del mundo. Sentirá un propósito en toda la organización, ya que sabemos que nuestro trabajo mejora los resultados para millones de pacientes.

Los productos y terapias de Baxter se encuentran en casi cada hospital del mundo, el clínicas y en los hogares. Por más de 85 años hemos sido pioneros en innovaciones médicas significativas que transforman el cuidado en salud.

Juntos creamos un lugar donde somos felices, exitosos y nos inspiramos mutuamente. Aquí es donde puedes hacer tu mejor trabajo.

Únete a nosotros en la intersección de salvar y sostener vidas-donde tu propósito acelera nuestra misión.

Your role at Baxter

The Professional Medical Services Administrator will manage our Welch Allyn, Inc. RetinaVue Network by providing professional governance, technical expertise, and management of the day-to-day operations of RetinaVue's Telehealth Program and initiatives. In addition, this role will interact daily with the Chief Medical Director of RetinaVue, P.C., the relevant entity Provider Groups, and work closely with a network of board-certified, state-licensed ophthalmologists and retina specialists dedicated to RetinaVue's Professional Medical Services in the U.S. This individual will also support the S&OP process for our Front Line Care US portfolio along with marketing operations processes.

What you'll be doing

Key Responsibilities

RetinaVue, P.C. – Professional Medical Services

• Lead all aspects of physician licensing and credentialing and maintain compliance with state and federal regulations.
• Collaborate with cross-functional partners, including Legal and Compliance, Sales, Project Managers, Finance, and Software Engineers, a critical component of this work.
• Manage aspects of the daily operations and functions by providing leadership and strategic direction to internal team members
• Oversee all non-clinical, technical, business, support, and regulatory activities
• Contribute to the development of RetinaVue Telehealth Program by serving as the expert in remote professional medical services
• Recruit, onboard, train and stewardship of network physicians along with physician retention
• Serve as a liaison between Welch Allyn/Baxter and consulting physicians
• Conduct, coordinate, chair, and support Credentialing Committee and Director meetings, including scheduling, preparation, facilitation, and documentation of meetings
• Develop, implement, and continuously improve credentialing, re-credentialing, and privileging processes, policies, and procedures to ensure compliance with regulatory requirements
• Coordinate credentialing services by hosting weekly meetings to review licenses, reappointment applications, and expirable documentation. Complete audits and assessments
• Oversee the end-to-end initial and re-credentialing process for providers
• Lead The Joint Commission accreditation and reaccreditation processes every three years
• Responsible for all contractual relationships, including its owners, the physicians, our management services agreement, and how those ultimately inform our customer relationships.
• SCS reports to the Manager of Professional Medical Services
• Tactical execution of contract obligations including but not limited to the management services fee, physician compensation, licensing, credentialling, and customer
• Individual actively ensure comprehensive, compliant 50 state coverage of professional medical services, ensuring cost effective business continuity
• Establish KPIs and operating mechanisms that create simplicity and speed in our contracting process.

Legal and Compliance

• Engage with outside counsel and third-party partners as needed for business regulations and standards
• Monitor and coordinate OIG/GSA Exclusion checks for federal healthcare programs, including Medicare and Medicaid
• Assist with customer audits
• Ensure and update policies and procedures, and Independent Contractor policies according to TJC and NCQA guidelines
• Ensures compliant 50 state operation of our professional medical services

Financial

• Develop and maintain annualized operating plan. Maintain partnership with FP&A on costs variance as required.
• Review and adjust the management services fee as our cost to provide those services changes
• Manage, review, and process physician over-read payments and Director expenses
• Manage and keep records of taxes, and liabilities (e.g., insurance)
• In