Operations Manager – MSO/IPA
Job Qualifications & Requirements
· Office-based position with travel to affiliated provider practices.
· Ability to attend meetings at multiple practice locations.
· Valid driver's license and reliable transportation.
· Current, active knowledge of the daily operations of a Management Services Organization (MSO) or Independent Practice Association (IPA).
· Current knowledge of Medicare Risk Adjustment, HEDIS, Medicare Advantage, and quality improvement initiatives.
· Excellent communication, organizational, and interpersonal skills.
· Ability to work independently while managing multiple priorities.
Job Responsibilities
· Coordinate provider onboarding and orientation for newly affiliated providers.
· Serve as the primary liaison between providers and health plans by building and maintaining strong professional relationships with affiliated providers and physician practices.
· Support provider engagement initiatives through education, training, performance monitoring, and practice improvement activities.
· Provide compliance training to providers and office staff and ensure completion of all required compliance requirements.
· Assist physician practices in achieving quality goals by closing care gaps through chart reviews, medical record collection, member outreach, and documentation improvement.
· Coordinate and support in-office quality events, including eye exams, Dexa scans, Annual Wellness Visits, and other preventive care services designed to close open care gaps.
· Conduct monthly meetings with providers to review quality performance, operational issues, and health plan initiatives. Document meeting attendees, discussion topics, action items, and follow-up plans.
· Research and resolve claims issues by coordinating with the appropriate internal departments and health plans.
· Receive, investigate, and respond promptly to provider questions, concerns, and emails.
· Investigate and communicate provider and practice staff changes to the appropriate internal departments and contracted health plans.
· Monitor provider performance and assist practices in meeting HEDIS, Medicare Risk Adjustment, and quality performance goals.
· Collaborate with internal departments to improve operational efficiency, provider satisfaction, and patient outcomes.
· Maintain confidentiality and ensure compliance with CMS, HIPAA, health plan requirements, and organizational policies.
Job Type: Full-time
Pay: $50,000.00 - $55,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Experience:
- MRA: 1 year (Preferred)
- MSO and IPA: 1 year (Preferred)
- Supervising: 1 year (Preferred)
- HEDIS: 1 year (Preferred)
Willingness to travel:
Work Location: In person
