Virginia Premier Health Plan Practice Manager in Roanoke, Virginia

About Us

Don’t just find a job, find your WHY at a purpose-driven organization; discover a career at Virginia Premier.

By blending quality benefits, affiliating with the world-renowned VCU Health System and offering career-advancing development programs, we allow our employees to focus on the meaningful work of improving and saving the lives of more than 200,000 people throughout the state of Virginia.

At Virginia Premier, we are building an industry leading health care organization through dedicated teams that have heart, provide top-notch quality member services and embrace our mission of inspiring healthy living within the communities we serve. Our vision is to connect people to innovation, quality and affordable health care for all phases of life.

If this sounds like you, read on!

Overview

Under the direction of the Clinic Medical Director, the Practice Manager is responsible for the management of facility resources and staff in compliance with established policies and procedures. Assures that the clinic is running smoothly and that patient flow is optimized.

Responsibilities

  • Maintains established policies and procedures, objectives, quality assurance program, safety, environmental and infection control standards.

  • Ensures that staff and providers maintain VPHP standards.

  • Manages all front office operations including but not limited to scheduling, check in/out process, copay management and transportation scheduling.

  • Assures that adequate staffing is present through the scheduling of clinic staff.

  • Oversees the process for re-assigning patients if a provider is out of the office.

  • Oversees the referral process, claims processing and medical record requests.

  • Assures that the clinic meets all applicable regulatory and internal standards. Participates in regulatory/insurance audits and inspections.

  • Manages programs as necessary to assure that an adequate level of supplies and equipment are present in the facility. Makes suggestions for additions and replacements of equipment.

  • Evaluates staff performance on a regular basis including verbal/written disciplinary action and annual performance reviews.

  • Provides input to Medical Director regarding the performance of all providers working at the clinic.

  • Interacts with Medical Director regularly to ensure appropriate operational and clinical service delivery.

  • Addresses patient grievances for the Medical Home promptly, utilizing customer service skills. Makes recommendations for and/or implements resolution as determined necessary.

  • Participates in the development of education programs and attends meetings as required. Attends education programs as needed.

  • Handles the provider credentialing process for hospital privileges.

  • Maintains professional growth and development.

  • Ensures accurate maintenance of patient’s medical records and the patient records are treated as confidential information

  • Maintains a safe and comfortable environment for patients and families.

  • As applicable, maintain skills in back office and front office departments so as to provide back up for these positions.

The Practice Manager will also serve as the Privacy Officer for the Medical Home. Some of the duties that the Privacy Officer is responsible for are:

  • Creating, posting and distributing the;

  • In facilities with, securing and recording each patient'sof receiving it;

  • Meeting requests forof health records;

  • Considering requests forfor, orof, particularly sensitive health information;

  • Providing information to patients (or staff) who have questions about HIPAA or state privacy protections; and

  • Handling anyfrom patients (or staff) about possible HIPAA violations.

Qualifications

MINIMUM EDUCATION/EXPERIENCE/LICENSURE

  • Minimum Education: Bachelor’s Degree in business or healthcare administration is required. 5 or more years of healthcare experience in a practice manager role in an outpatient medical setting that exceeds 5 years may be considered in lieu of the Bachelor’s degree.

  • Customer Service, Human Resource and Financial Management training preferred.

  • 2-5 years management experience in patient care delivery field, preferably in a medical office environment/clinic environment is strongly preferred. Experience with acquiring and maintaining the Patient Centered Medical Home accreditation is also strongly preferred.

KNOWLEDGE, SKILLS AND ABILITIES

  • Proven effective communication, collaboration and teamwork skills.

  • Proven effective experience working on an interdisciplinary team.

  • Strong and proven computer/typing skills

  • Knowledge and experience with process improvement and Six Sigma initiatives.

  • Demonstrate the ability to work effectively with a diverse set of employees and patients with multiple disciplines in both clinic and administrative settings.

  • Knowledge and experience in the areas of employee development, leadership and communication.

PHYSICAL REQUIREMENTS

  • Physical health sufficient to meet the ergonomic standards and demands of the position.

About Us

Virginia Premier is a managed care organization which began as a full-service Medicaid MCO in 1995. Partnered with VCU Medical Systems we strive to meet the needs of the underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable Medicare and Medicaid healthcare programs. Headquartered in Richmond, VA we also have offices in Roanoke, Tidewater and Bristol with additional satellite locations allowing us to serve over 200,000 members across eighty counties throughout Virginia.

We offer competitive salaries and a comprehensive benefits package to include excellent Medical, Dental and Vision Plans, Tuition Assistance, Infant-At-Work Program, Remote Work options and generous vacation and sick leave policies. Our culture supports an environment where employees can continuously learn and gain professional growth through various development programs, education, exciting projects and career mobility.

All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE

Our mission is to inspire healthy living within the communities we serve!

Job ID 2018-5436

As an equal opportunity employer, Virginia Premier is committed to a diverse workforce. To ensure non-discrimination and affirmative action for individuals protected by Executive Order 11246, as amended, Section 503 of the Rehabilitation Act of 1973, as amended, the Vietnam Veterans’ Readjustment Act of 1974, as amended, and Title I of the Americans with Disabilities Act of 1990, as amended, Virginia Premier will consider applicants for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. Applicants who require accommodation in the job application process may contact Recruitment at 804-819-5151 for assistance. It is the policy of Virginia Premier Health Plan, Inc., to comply with the requirements of the Drug-Free Workplace Act of 1988. It is a violation of our drug-free workplace policy to use, possess, sell, trade, and/or offer for sale alcohol, illegal drugs or intoxicants in our workplace. Federal law requires all employers to verify the identity and employment eligibility of all persons hired to work in the United States. Virginia Premier participates in E-verify.