Serves as the primary liaison between the Company and the Peer Reviewer panels required for Commence’s contract work
Relays questions, concerns, and other operational information between the Medical Director, Project Director(s), and Peer Reviewers
Assists in the day-to-day maintenance of Commence’s required Peer Reviewer panels
Manages onboarding and offboarding of all new PRs, including background check paperwork, licensing check, W-9 completion, Small Business Certification (if required), access requests, input of rates into CompassWeb and distribution of training materials
Ensures that each new PR has a signed contract on file and computer access to perform the job
Ensures that each PR has access to each internal and government platform and instruct them on how to set up those accounts
Follows up on all recruitment leads from all sources, including the current panel(s)
Prepares agreements for each new PR, ensuring that the correct agreement template is used, and that the required credentials are added properly
Initiates and monitors PR training on computer systems and Company procedures
Maintains a master database available to managers and staff of all active and past PRs and their contact information, states of license, specialties, onboarding progress, small business types, case preferences, and language proficiency
Prepares monthly PR reimbursement reports
Maintains a monthly running tab of PR reimbursements to stay within contract limits
Serves as the point of contact for PR payment issues, including billing and reimbursement issues
Performs and documents yearly licensure, board certification, and other required verifications
Serves as the point of contact for business development on PR questions
Ensures the Medical Director and Project Director(s) are kept informed and up to date on the status of the PRs to include contract status and any issues with PRs and onboarding and offboarding status
Protects the confidentiality of patient information through compliance with the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH)
Completes annual security awareness training and testing, rules of conduct training, and conflict of interest training
Assists in recruiting specialists as needed, via mailings to medical societies, training program inquiries, etc.
Distributes PR educational material
Continually updates the database of teaching material and Medical Director letters to the PR panel
Provides administrative support for the medical director, including set-up and maintaining internal quality control (IQC) cases for monthly medical director quality review
Requirements
An associate degree plus three years of experience OR Bachelor’s degree plus two years of experience related to a majority of the essential functions of the job
Experience and skills in processing Excel spreadsheets and using presentation software applications
Familiarity with database software programs (e.g., Microsoft Office)
Ability to use multiple cloud-based platforms
Knowledge of the health care system, the health professions, and the medical specialties
Licensed Practical Nurse (LPN) or Registered Nurse (RN) licensure is preferred but not required
Excellent written and verbal communication skills
Ability to compose and edit various complex documents and ensure that documents are grammatically correct and error-free
Strong analytical ability and problem-solving skills
Ability to work as a team member by maintaining good working relationships with co-workers, management, and customers
Ability to organize and coordinate multiple simultaneous tasks in a team environment
Ability to work independently with minimal supervision
Additional hours may be required, with flexibility to adjust schedule with little or no notice
Benefits
Equal employment opportunity employer
Provides reasonable accommodations for individuals with disabilities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
written communicationverbal communicationteamworkorganizational skillsindependenceflexibilityrelationship managementattention to detailtraining facilitationconfidentiality