RN Client Account Manager

The Client Account Manager’s role is to oversee the day-to-day operations of their assigned clients and to develop strong, trusting relationships with them. This will include acting as a liaison with internal teams and Payer clients to improve the entire customer experience.

TASKS AND RESPONSIBILITIES:

• Develop an in-depth understanding of MRO’s Payer Solutions program that includes payer and provider relationships, onboarding and maintenance activities such as data validation, data mapping, data processing, crosswalk code applications, product performance, and service desk management
• Develop an in-depth knowledge of quality measures for HEDIS (Healthcare Effectiveness Data and Information Set) and Government Programs and Risk Adjustment
• Own the management, communications and relationships with assigned provider groups, independent practices or health systems
• Translate technical knowledge to business concepts in client management and communications
• Utilize appropriate escalation points and methods when necessary
• Advocate for assigned provider clients by communicating their business needs and priorities to payers and internal MRO leadership
• Use critical thinking and identify client impacts of operational activities, issues, product enhancements and industry trends in clinical data exchange
• Build and maintain strong, long-lasting client relationships, through proactive and regular communications
• Monitor service desk issues from assigned provider clients and ensure prompt and accurate answers to clients’ questions, concerns and measure performance concerns.
• Provide payer clients regular updates on providers’ status during onboarding, maintenance and any associated risks and data quality issues. Proactively identify risks for assigned clients, mobilize internal team members to investigate issues and update clients and leadership of resolutions and plans of action
• Train clients and internal staff on how to use MRO products
• Ensure policy and data handling compliance
• Train and mentor team members on measurement requirements, data validation, and clinical concepts for data capture. Work closely with provider clients and MRO clinical experts to provide timely, qualitative feedback and understand customer unique capabilities and requirements
• Utilize JIRA dashboard, reporting trackers, PowerPoint, and Microsoft Project effectively to communicate all practice onboarding, maintenance, and delivery activities to Payer clients.
• Document all onboarding details of primary source verification while collaborating with multidisciplinary teams to map and resolve data discrepancies
• Ensure effectiveness of cross functional internal meetings
• Investigate data issues in detail utilizing critical thinking, root-cause-analysis, and summarize details in SBAR format.
• Other duties as assigned

SKILLS|EXPERIENCE:

• RN, BSN, MSN
• A minimum of 2-year clinical experience in physician office, hospital, or – managed care company setting.
• Experience in data-driven quality improvement projects in a healthcare setting, especially involving EHR (Electronic Health Record) – workflows or clinical documentation improvements preferred.
• Candidates should have experience working with one or more Electronic Health Records and/or Practice Management software systems.
• Communicates effectively both written and verbally to groups of people and/or individuals at all levels of an organization both internally and externally
• Detail-oriented and data-driven approach to problem solving
• Ability to prioritize and manage multiple provider clients at the same time
• Must be a self-starter and be able to work independently and in a team environment with minimal supervision
• Ability to work in a fast-paced environment, process changes, learn innovative technology or processes quickly
• Proficient with Microsoft Office
• Ability to understand measure requirements for HEDIS, STARS, ACOs and others, and determine data capture and delivery requirements
• Knowledge and understanding of risk adjustment and medical coding (ICD, CPT and other coding standards), including healthcare data standards such as HL7, CCDA, QRDA (Quality Reporting Document Architecture)
• Previous management experience preferred
• Ability to coordinate and supervise offshore team members