Provider Network Coordinator

Provider Network Coordinator

Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care. Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help. Everyone on our team from our doctors, nurses, and Care Specialists to our HR, Technology, and Business Services staff are driven by a desire to improve the lives of our patients. We are able to treat a wide range of needs everything from addressing poorly controlled blood sugar to combatting anxiety to accessing medically tailored meals because we know that health requires care for the whole person. It's no wonder 98% of patients report being fully satisfied with Upward Health!

The Provider Network Coordinator (PNC) plays a critical role in advancing Upward Health's mission by identifying, developing, and maintaining a comprehensive network of external clinical providers. This includes primary care physicians, specialists, hospitals, skilled nursing facilities, and ancillary services such as paramedicine, laboratory, imaging, and pharmacy. The PNC ensures that all necessary services and supports are available to patients, collaborating with external providers to improve care outcomes, enhance quality metrics, reduce hospital readmissions, and ensure smooth care transitions. This role is ideally suited for someone who lives within the community Upward Health serves and has a deep understanding of the clinical resources available to patients.

Skills Required:

• Strong background in establishing and maintaining relationships with healthcare providers, hospitals, and other clinical service partners.
• Ability to effectively collaborate with internal teams and external providers to coordinate patient care and resources.
• Ability to use data to identify high-priority providers, address gaps in care, and develop targeted strategies to improve patient outcomes.
• Experience in building partnerships with external clinical providers and engaging with community stakeholders.
• Excellent verbal and written communication skills, able to effectively interact with clinical partners, patients, and internal teams.
• Skilled at managing multiple priorities and coordinating schedules across various stakeholders, ensuring timely care for patients.
• Ability to think critically and adapt strategies to meet the evolving needs of patients and external partners.

Key Behaviors:

Relationship-Building:

• Develops and nurtures strong, long-lasting relationships with external clinical providers, community organizations, and internal care teams to support patient care.

Collaboration:

• Works closely with both internal and external teams, ensuring effective communication and collaboration in achieving high-quality patient care.

Patient-Centered Approach:

• Always prioritizes patient needs by ensuring access to the most appropriate clinical resources and services.

Adaptability:

• Demonstrates flexibility in adjusting strategies and processes based on changing patient needs, data, and external partner availability.

Accountability & Initiative:

• Takes ownership of responsibilities, proactively addressing issues and opportunities to improve patient care and service delivery.

Attention to Detail:

• Ensures that all interactions with providers and partners are documented accurately and comprehensively, maintaining up-to-date provider directories and service records.

Competencies:

External Provider Network Development:

• Expertise in identifying, building, and maintaining a strong network of primary care, specialty care, hospital, and ancillary service providers.

Data-Driven Decision Making:

• Strong ability to analyze data (e.g., patient-specific reports, quality metrics) to drive decisions and improve outcomes.

Quality Improvement:

• Focus on driving continuous improvements in care quality, including addressing gaps in care and reducing hospital readmissions.

Care Transition Management:

• Proficient in facilitating smooth care transitions, ensuring follow-up and coordination post-hospitalization or after an emergency department visit.

Negotiation & Influencing:

• Ability to effectively negotiate and influence external clinical partners to ensure quality and timely care for patients.

Cultural Competency:

• Skilled in interacting with individuals from diverse cultural and socioeconomic backgrounds, ensuring culturally sensitive care.

Communication & Stakeholder Engagement:

• Strong verbal and written communication skills to engage and collaborate with diverse stakeholders, including providers, patients, and internal teams.

Upward Health is proud to be an equal opportunity employer. We are committed to attracting, retaining, and maximizing the performance of a diverse and inclusive workforce. This job description is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position.