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Provider Relations Representative works as the primary liaison between Community First Health Plans and network participants (physicians, providers, and administrators) of the health plan provider network.
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The Manager of Provider Relations will serve as the point person for managing the day-to-day relationship between MetroPlusHealth and top level administrators at each assigned network facility and community providers.
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ResponsibilitiesThe Provider Relations Representative is responsible for establishing and maintaining positive relationships with various clients building strong, cohesive business partnerships.
$24.96 - $34.31 an hourFull-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Experience in other provider related healthcare departments such as credentialing, provider relations or contracting preferred. Two (2) Years Experience In Provider Services Required.
RemoteExpandApply NowActive JobUpdated 16 days ago - UpvoteDownvoteShare Job
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Experience in Facets, or similar provider data or claims processing system. " Provider data entry experience. Experience in provider data healthcare. Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services self-funded employee health benefit plan.
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Recent experience as a provider relations representative, member service representative, or relevant claim experience is highly preferred. The Provider Relations Representative knows and abides by all organizational and departmental policies, sets personal standards, and strives for high quality work in completing assignments, performs job duties in a timely manner, and represents the organization in a positive manner.
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1 - 5 years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience. Provider Engagement Professional- Conviva Daytona page is loaded.
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The Provider Performance Manager is a key member of a cross-functional, collaborative organization (which includes Market Provider Performance, Sales, Health Services, Clinical, Stars & Risk Adjustment, Finance, Marketing, Cross-Segment Contracting, Provider Relations, and Network Development & Solutions.
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PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled nursing facilities, public health organizations and post-acute care organizations. Ten (10) or more years of health-plan contracting or provider experience required.
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Preferred: PALS, CPR Instructor, refined public relations, verbal and writing expertise. Required: ACLS (within 3 months), BLS (AHA Healthcare Provider), PALS if supervise pediatric department.
$87,261 - $107,798 a yearFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Manages provider data management system and oversees vendor relations for provider data management system maintenance. Collaborate with Contracting, Provider Relations, Credentialing, Claims and Regulatory Compliance Affairs to gather and synthesize requirements, establish data standards and monitor data integrity and process flow effectiveness.
$117,000 - $192,390 a yearFull-timeRemoteExpandUpdated 1 month ago - UpvoteDownvoteShare Job
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Rosecrance is a leading non-profit provider of comprehensive behavioral health services in the United States. Serve as a role model for other staff, patients and customers and demonstrate positive guest relations in representing Rosecrance.
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StormGeo is a global provider of weather intelligence and decision support services, with leading solutions for shipping, oil and gas, renewable energies, utilities, other onshore industries, and aviation.
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In collaboration with the HR Team, the Labor and Employee Relations Manager will also assist in providing “Level One” help to PAGNY provider in the absence of the HR Generalist, CAO or other staff on issues including, but not limited to CMEs, health and retirement benefits, payroll (e.g., Paycom, completing timesheets), leave, and resignations.
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Collaborates with Provider Relations and other provider facing teams to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters.
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