Professional Medical Services Manager

Company: Baxter Healthcare
Location: Chicago
Posted on: February 15, 2025

Job Description:

This is where you save and sustain livesAt Baxter, we are deeply connected by our mission. No matter your role at Baxter, your work makes a positive impact on people around the world. You'll feel a sense of purpose throughout the organization, as we know our work improves outcomes for millions of patients.Baxter's products and therapies are found in almost every hospital worldwide, in clinics and in the home. For over 85 years, we have pioneered significant medical innovations that transform healthcare.Together, we create a place where we are happy, successful and inspire each other. This is where you can do your best work.Join us at the intersection of saving and sustaining lives- where your purpose accelerates our mission.Your role at BaxterThe Professional Medical Services Administrator will manage our Welch Allyn, Inc. RetinaVue Network by providing professional governance, technical expertise, and management of the day-to-day operations of RetinaVue's Telehealth Program and initiatives. In addition, this role will interact daily with the Chief Medical Director of RetinaVue, P.C., the relevant entity Provider Groups, and work closely with a network of board-certified, state-licensed ophthalmologists and retina specialists dedicated to RetinaVue's Professional Medical Services in the U.S. This individual will also support the S&OP process for our Front Line Care US portfolio along with marketing operations processes.What you'll be doingKey ResponsibilitiesRetinaVue, P.C. - Professional Medical Services

• Lead all aspects of physician licensing and credentialing and maintain compliance with state and federal regulations.
• Collaborate with cross-functional partners, including Legal and Compliance, Sales, Project Managers, Finance, and Software Engineers, a critical component of this work.
• Manage aspects of the daily operations and functions by providing leadership and strategic direction to internal team members.
• Oversee all non-clinical, technical, business, support, and regulatory activities.
• Contribute to the development of RetinaVue Telehealth Program by serving as the expert in remote professional medical services.
• Recruit, onboard, train and steward network physicians along with physician retention.
• Serve as a liaison between Welch Allyn/Baxter and consulting physicians.
• Conduct, coordinate, chair, and support Credentialing Committee and Director meetings, including scheduling, preparation, facilitation, and documentation of meetings.
• Develop, implement, and continuously improve credentialing, re-credentialing, and privileging processes, policies, and procedures to ensure compliance with regulatory requirements.
• Coordinate credentialing services by hosting weekly meetings to review licenses, reappointment applications, and expirable documentation. Complete audits and assessments.
• Oversee the end-to-end initial and re-credentialing process for providers.
• Lead The Joint Commission accreditation and reaccreditation processes every three years.
• Responsible for all contractual relationships, including its owners, the physicians, our management services agreement, and how those ultimately inform our customer relationships.
• SCS reports to the Manager of Professional Medical Services.
• Tactical execution of contract obligations including but not limited to the management services fee, physician compensation, licensing, credentialing, and customer.
• Actively ensure comprehensive, compliant 50 state coverage of professional medical services, ensuring cost-effective business continuity.
• Establish KPIs and operating mechanisms that create simplicity and speed in our contracting process.Legal and Compliance
  • Engage with outside counsel and third-party partners as needed for business regulations and standards.
  • Monitor and coordinate OIG/GSA Exclusion checks for federal healthcare programs, including Medicare and Medicaid.
  • Assist with customer audits.
  • Ensure and update policies and procedures, and Independent Contractor policies according to TJC and NCQA guidelines.
  • Ensure compliant 50 state operation of our professional medical services.Financial
    • Develop and maintain annualized operating plan. Maintain partnership with FP&A on costs variance as required.
    • Review and adjust the management services fee as our cost to provide those services changes.
    • Manage, review, and process physician over-read payments and Director expenses.
    • Manage and keep records of taxes, and liabilities (e.g., insurance).
    • Intimately understand how our contract service types map to revenue and cost performance. Analyze month on month variability to lead change and improve business predictability.
    • Maintain compliant financial reporting requirements at the individual legal entity level.What you'll bring
      • Bachelor's Degree required.
      • 5+ years of experience in a customer success, project management, credentialing or related field; healthcare experience highly desired.
      • Strong leadership capabilities and ability to initiate and maintain cross-functional relationships.
      • Ability to take actions and implement effective solutions in a timely manner and lead multiple priorities while working cross-functionally.
      • Skilled user of Excel, PowerPoint with the ability to learn new software systems quickly.
      • Able to analyze data quickly and thoroughly and provide actionable business recommendations based on data. Has a respect for data and analytical approaches to decision-making.
      • Experience in providing creative solutions to business challenges, with focus on organizational planning gaps.
      • Strong project and process management skills.
      • Good business/financial savvy and judgment.Equal Employment OpportunityBaxter is an equal opportunity employer. Baxter evaluates qualified applicants without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity or expression, protected veteran status, disability/handicap status or any other legally protected characteristic.Reasonable AccommodationsBaxter is committed to working with and providing reasonable accommodations to individuals with disabilities globally. If, because of a medical condition or disability, you need a reasonable accommodation for any part of the application or interview process, please let us know the nature of your request along with your contact information.
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Keywords: Baxter Healthcare, Chicago , Professional Medical Services Manager, Executive , Chicago, Illinois