GENERAL SUMMARY:
The Senior Provider Service Administrator (SPSA) is the plan representative with key providers and PHO/PO groups who participate in value based and fee-for-service contracts with the health plan. The SPSA represents HAP at external forums and various healthcare and community wide coalitions; develops and maintains beneficial relationships with HAP’s provider community such as physicians, hospitals, ancillaries, and network PHO/PO administrators. The SPSA performs analysis, leads discussions with external and internal audiences, coordinates solutions within HAP’s internal departments including risk adjustment, quality, financial and health care management and executes solutions related to containment of medical costs. The SPSA administers value-based contract arrangements and programs with provider groups.

PRINCIPLE DUTIES AND RESPONSIBILITIES:

+ Develops and presents PHO/PO reports related to risk adjustment, quality including HEDIS/Medicare ...