Job Details

Thank you for considering a career at Roper St. Francis Healthcare!

Scheduled Weekly Hours:

40

Work Shift:

Days (United States of America)

This position is based at our Palmetto Commerce Parkway Office Park in Ladson, SC. While partial remote or hybrid work may be available, candidates must be able to commit to regular onsite presence.

Primary Function/General Purpose of Position

Under the guidance of the Roper St. Francis Health Alliance (RSFHA) Director of Operations, the CIN Operations Specialist coordinates initiatives and day-to-day operations of the Clinically Integrated Network (CIN). The Operations Specialist will provide concise and relevant information to the Director to assist in the development and execution of strategies and network development. This position will aid in the support of the RSFHA Board of Directors and its Subcommittees through project management of annual recurring and ad hoc projects (ex. annual network membership reviews, provider compliance with participation requirements, etc.)

Essential Job Functions

Provider Membership Management – RSFHA lead for working with providers to execute and renew participation agreements and addendums as needed. Responsible for maintaining database of participation agreements, provider compliance with participation requirements and provider rosters. Provider roster management includes ongoing capture and verification of all provider info needed to operate online provider search tools, submit rosters for claims processing, manage prioritization of “refer-to” providers in EHR and conduct other important RSFHA business.

Patient Communications – RSFHA lead for [1] general marketing and [2] individual patient assistance. Responsible for working with RSF Marketing team to develop and execute RSFHA's annual marketing plan to include patient mailers, annual enrollment materials and other patient-facing marketing materials. Also responsible for responding to individual patient and family member issues, requests, etc. This includes out-of-network waiver review, escalated complaints, complex access issues and other similar needs.

RSFHA Network Management – RSFHA lead assigned to support the RSFHA Professional Standards and Credentialing committee. Responsible for working with committee chair and RSFHA leadership to conduct annual network membership review, review provider participation requirements, manage corrective action process, review network ancillary/wrap providers, etc.

Payor and Employer CIN Operations – RSFHA lead for all employer annual enrollment activities including messaging, presentations and promotions. Responsible for working with RSF Marketing and IS to develop and maintain patient-facing online provider search tools. Responsible for working with payors to submit network rosters and TIN files such that claims process according to RSFHA network status. Responsible for working with payors and employers to address annual review of network structure - wrap network and ancillary providers. Responsible for coordinating and managing waiver process for out of network exceptions.

Ad Hoc CIN Projects – Supports ad hoc CIN projects as needed. Examples include coordination with SNF's to support post-acute care, coordination of on-site events at client companies, etc.

Provider Communications – RSFHA lead responsible for developing and executing RSFHA's provider communications plan. Requires regular, ongoing collaboration with RSF Marketing Liaison team.

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.

Licensing/Certification

CAPM or PMP preferred.

Education

Bachelor's degree required, prefer degree in Business, Finance or related field.

MBA or MHA required.

Work Experience

Three to five years of experience in healthcare administration or project management required.

One to two years of ACO/CIN experience strongly preferred.

Experience supporting large-scale organizational projects preferred.

Training

N/A

Language

N/A

Patient Population

Demonstrates the knowledge and skills necessary to provide care appropriate to the age of the patients served on his or her assigned unit.

Demonstrates knowledge of the principles of growth and development of the life span and possesses the ability to assess data reflective of the patient's status and interprets the appropriate information needed to identify each patient's requirements relative to his or her age, specific needs and to provide the care needed as described in departmental policies and procedures.​

Neonates (0-4 weeks)

Infant (1-12 months)

Pediatrics (1-12 years)

Adolescents (13-17 years)

Adults (18-64 years)

Geriatrics (65 years and older)

X Not applicable to this position

Working Conditions

This section addresses the physical environment in which the employee will perform the work.

X Periods of high stress and fluctuating workloads may occur.

X Long-distance or air travel as needed- not to exceed 10% travel.

X General office environment.

May be exposed to high noise levels and bright lights.

May be exposed to physical altercations and verbal abuse.

May be exposed to limited hazardous substances or body fluids.*

May be required to use physical restraints.

May be exposed to human blood and other potentially infectious materials.*

May be exposed to adverse weather conditions; cold, hot, dust, wind, etc.

X May have periods of constant interruptions.

X Required to car travel to off-site locations, occasionally in adverse weather conditions.

X Prolonged periods of working alone.

____ Other:

____ Not applicable to this position

* Individuals in this position are required to exercise universal precautions, use personal protective equipment and devices, and learn the policies concerning infection control.

Physical Requirements

This section addresses the physical demands and work position of the associate in the role.

Physical Demands

Frequency 0% 1-33% 34-66% 67-100%

Lifting/ Carrying (0-50 lbs.) X

Lifting/ Carrying (50-100 lbs.)

Push/ Pull (0-50 lbs.) X

Push/ Pull (50-100 lbs.) X

Stoop, Kneel

Crawling

Climbing

Balance

Bending

Work Position

Frequency 0% 1-33% 34-66% 67-100%

Sitting X

Walking X

Standing X

Additional Physical Requirements/Hazards

Physical Requirements

Manual dexterity (eye/hand coordination)

Perform shift work

Maneuver weight of patients

Hear alarms/telephone/audio recordings

Reach above shoulder

Repetitive arm/hand movements

Finger Dexterity

X Color Vision

X Acuity – far

Acuity – near

____ Not applicable to this position

Hazards

Depth perception

Use of Latex products

Exposure to toxic/caustic/chemicals/detergents

Exposure to moving mechanical parts

Exposure to dust/fumes

Exposure to potential electrical shock

Exposure to x ray/electromagnetic energy

Exposure to high pitched noises

Gaseous risk exposure

Other:

X_ Not applicable to this position

Skills

Hard/Tech/Clinical Skills:

Identify process improvements

Develop new processes/procedures to improve quality

Perform all functions assigned in an accurate and timely manner, as well as the ability to organize and present information in a neat and effective manner

Strong written and verbal communication skills

Highly proficient in MS Excel, PowerPoint, Outlook and Word

Able to utilize standard project management processes, tools and methodologies as needed​

Soft/Interpersonal Skills:

Attention to detail

Critical thinking and analysis

Communication with team members

Teamwork

Conflict resolution

Active listening

Relationship building

Roper St. Francis Healthcare is an equal opportunity employer.

Many of our opportunities reward* your hard work with:

• Comprehensive, affordable medical, dental and vision plans

• Prescription drug coverage

• Flexible spending accounts

• Life insurance w/AD&D

• Employer contributions to retirement savings plan when eligible

• Paid time off

• Educational Assistance

• And much more

*Benefits offerings vary according to employment status.

Department:

PP - Accountable Care Organization - Roper St. Francis Health Alliance

It is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a). Accordingly, all applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at ...@RSFH.com .