Provider Relations Representative

Responsibilities Act as the primary liaison between the Fund and provider network Perform virtual site visits to participating providers to offer continued education and training Coordinate and conduct provider recruitment activity, network analysis including contracts and network retention to ensure network adequacy Update participating providers regarding new policies and procedures. Review existing policy to ensure maximum compliance, troubleshoot issues raised by provider and distribute any needed material Identify non-compliant providers, and providers with member complaints; communicate provider specific problems to management and propose remedy Responsible for keeping abreast of departmental specific goals and reinforcing these goals to providers Maintain accurate records of contacts and reports Perform additional duties and projects assigned by management Qualifications Bachelor’s degree in business or health related field Minimum two (2) years managed care, provider contracting or provider services experience required Basic skill level in Microsoft Word and Excel preferred Knowledge of healthcare terminology required; familiarity with contracting language and fee negotiations Ability to travel throughout assigned territories Excellent written and oral communication skills; effective customer service skills Excellent interpersonal skills; ability to maintain productive work relationships with various providers, departments, and professionals at all levels Good problem solver with excellent analytical skills Demonstrated organizational skills, record keeping, and time management skills Able to work well independently, handle multiple projects and assignments, and follow through to completion Must meet performance standards including attendance and punctuality