Provider & Member Liaison Coordinator - Kepro

Company Description

Kepro and CNSI have merged.

Kepro is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, and in the right setting.

Job Description

Provider & Member Liaison Coordinator (RN)

• Are you an experienced Provider & Member Liaison Coordinator looking for a new challenge?
• Do you value care management and quality improvement?
• Are you motivated, energetic, and excited to become part of the Kepro team?

If so, you might be our next new team member!

Who we need:

The Provider & Member Liaison Coordinator is a key position on the Indiana Utilization Management contract. This position is critical to introducing providers to the Kepro system and policies and assisting members with ensuring their needs are met. The individual within this role will have regular communication with providers and members via multiple mediums. Training providers on our system and educating them on critical submission policies are central to the role. This includes being responsible for training activities and available for technical assistance. In addition, this position is responsible for working closely with the Program Director and/or Clinical Manager to hold stakeholder meetings and querying providers related to satisfaction. This position will also work closely with members to address any member concerns or needs.

People Focused. Mission Driven.

Shape the future of healthcare with us. We are mission-driven to improve lives through healthcare quality and clinical expertise.

We do this through our people.

At Kepro, you can do meaningful work that makes a real difference for the lives of individuals across the country. We are an organization that cares deeply about our employees, and we provide the training and support to do the best work of your career.

Benefits are a key component of your rewards package at Kepro. These benefits are designed to provide you and your family additional protection, security, and support for both your career and your life away from work. They are comprehensive and fit a variety of needs and situations. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

What you’ll do:

• Provide orientation and ongoing technical assistance for new/existing providers.
• Create and Update Provider Manuals and User Guides
• Create educational training content for members
• Comprehensive knowledge of the Kepro ANG system and benefit-specific guidelines for all services on UM contract.
• Provide technical assistance when requested or identified to enrolled providers.
• Develop and conduct provider training sessions as contracted.
• Coordinate provider stakeholder meetings
• Coordinate provider satisfaction surveys
• Manage provider email boxes
• Assist in evaluating provider quality trends and developing tutorials to educate providers
• Perform ongoing training to providers on how to submit requests utilizing Kepro’s ANG system

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time

Qualifications

What you’ll need:

Required Qualifications

• Must have a Bachelor’s Degree in a Human Service/Education field or discipline.
• Master’s degree preferred

• Unrestricted Registered Nurse license for the State of Indiana or any compact state preferred

Knowledge, Skills, Abilities

• Must have the ability to review and analyze documentation against set standards.
• Knowledge of training or workplace learning methodology.
• Familiarity with computer applications and the ability to navigate through multiple screens.
• Knowledge of adult learning principles.
• Ability to maintain confidentially standards and HIPAA compliance when evaluating all pertinent issues.

Sense of urgency to meet deadlines.

Experience

• Minimum of 1 year of experience with prior authorization/utilization management and be Licensed as a Registered Nurse, Social Worker, Professional Counselor, Rehabilitation Counselor, Psychologist Experience, or Educator with customer service required. Effective communication skills, both verbally and in writing, are required.
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