Provider Liaison (Personal Services)

General Summary
Under the direction and supervision of the Supervisor, Network Performance, the Provider Liaison ensures that LifeWays and its contracted providers maintain a positive working relationship that is compliant with applicable standards while providing a great working experience for network staff. The Provider Liaison performs duties to support the mission and vision of LifeWays in its efforts to maintain a quality provider network to those we serve. This position also ensures that contractors comply with contractual expectations including all requirements mandated by the Michigan Department of Health and Human Services.
Essential Functions
Establishes and maintains a collaborative relationship with contracted provider agency leadership.Coordinates with the Provider Credentialing Administrator to conduct on-site audits to monitor provider agency compliance with contractual requirements for credentialing, training, certification, and service delivery.Responsible for communication between LifeWays and assigned provider agencies and facilitates Provider Meeting for assigned group of provider agencies.Uses independent judgment and creativity to assist the Leadership Team in working on provider contract/performance issues relative to assigned contracts.Conducts encounter reviews to ensure provider compliance with Medicaid Chapter III for claims reimbursement.Assesses provider situations, obtaining necessary information, drawing conclusions, and recommending and/or implementing courses of action in accord with normal practices and procedures. Alerts Director immediately of any significant problems, issues or risks associated with a contracted provider agency.Provides technical assistance to providers to improve provider performance.Responsible for adherence to all Commission on Accreditation of Rehabilitation Facilities (CARF) and Michigan Department of Health and Human Services (MDHHS) standards.
NOTE: The lists of essential and additional functions are not exhaustive. They may be supplemented as necessary from time to time.
Job Specifications (Knowledge, Skills, and Abilities)
At least three years experience in related environment and behavioral health field, preferred.Knowledge of provider audit processes and MDHHS/MSHN (Mid-State Health Network)/CARF technical standards.Knowledge of LifeWays service array and provider network.Knowledge of County of Financial Responsibility Rules.Knowledgeable about Medicaid Chapter III and Michigan Mental Health system.Responsive to the changing healthcare environment.Demonstrates excellent customer service with interpersonal, verbal, and written communication skills in a non-judgmental and friendly demeanor to all stakeholders, including the diverse populations served by LifeWays, which may include consumers who display challenging behaviors.Excellent time management skills in a setting with potential frequent interruptions; ability to coordinate multiple concurrent projects and perform tasks in an organized and timely manner, with attention to detail.Professional in appearance and demeanor, telephone, and interpersonal communications.Establishes and maintains professional working relationships with consumers, staff, providers and community partners with ability to solve problems and resolve conflict.Proficiency/Intermediate-to-advanced knowledge of Microsoft Office Suite applications (Word, Excel, PowerPoint, Outlook); and internet applications, including Electronic Medical Record. Ability to navigate LifeWays Intranet.Experienced using office equipment, including but not limited to cellular telephone; desktop VoIP telephone/voicemail; copier/fax machine/scanner/printer; computer; and calculator.Health Insurance Portability and Accountability Act (HIPAA) and other confidentiality regulations compliance required. LifeWays embraces an employment environment that will be knowledgeable about and actively supports a recovery-based, person-centered, and culturally competent practices. Lived experiences with mental illness, intellectual and developmental disabilities, and/or substance use disorders are valued.
Disclaimer
The above information on this description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees assigned to this job. The job description will be reviewed periodically as duties and responsibilities change with business necessity.