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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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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 4 days ago - UpvoteDownvoteShare Job
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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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The MSR also assists in the case management of Health Service Utilization, Care Management, Radiology Benefit Manager, Transportation coordination, and the Pharmacy Department, by being the Plan's point of contact for the member and provider/pharmacies in the facilitation and coordination of services with the appropriate provider.
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The Provider Recruiter and Relations Representative may work with providers on the TERM, and/or Medi-Cal Fee-For-Service (FFS) Network(s) as well as Off Panel, Out of Network providers, Skilled Nursing Facilities, Hospitals, which includes the San Diego County Psychiatric Hospital and/or Edgemoor Hospital, as well as other medical professionals.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Supports the implementation of business changes to simplify operations and improve all provider business experiences with HMSA. Requires regular off-site visits to resolve servicing issues, gather provider market intelligence, contract related concerns and provide education (more than 50% of time spent offsite) to ensure and strengthen relations with providers.
$53,996 - $79,258 a yearExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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The applicant dentist is notified by the Talent Acquisition (for staff model) or Provider Relations (for IPA) representative of any missing documents, so that the missing documents may be collected or the erroneous information can be corrected in writing to the Talent Acquisition or Provider Relations representative within 30 days, which is then forwarded to the Credentialing Coordinator.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Accountable for a full range of provider relations including engagement with and development of prospective providers. Responsible for a full range of provider relations and service interactions.
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We are very excited to welcome a Provider Relations Representative to our team in the brand-new La Quinta market. · Minimum of one (1) year of experience in provider network development and/or provider network management capacity, account management, or provider relations experience in a managed care organization required.
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Assists Provider Relations Representative with handling high volume of phone calls, emails, and documentation. Solves issues encountered by providers while processing claims in person, by email or telephonically through our established Provider Hotline.
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Manage business, community, regulatory, governmental, and external board relations in their Market. Reporting to the regional president, and working directly with Hospital Presidents, the Market President is responsible for the strategic planning, operations, profit and loss (P&L), employee & provider engagement, and support services within the market.
ExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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As a Provider Relations Field Representative and Trainer, you'll play a crucial role in nurturing strong relationships with medical and healthcare providers across the northwestern quadrant of Wyoming.
$53,000 - $65,000 a yearFull-timeExpandUpdated 1 month ago - UpvoteDownvoteShare Job
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Liaise directly with internal and external stakeholders including Global Benefits, Employee Relations, Legal, Payroll and 3rd party provider; if necessary, partner with HR Shared Services management to provide guidance to junior leave staff in cases that are complex or require escalation.
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Job Summary: Provider Relations Representative is responsible for assisting in the full range of provider relations and service interactions for all lines of business within Prominence Health Plan. Will assist in the design and implementation of programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.
ExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Initiate and maintain effective channels of communication with our high-quality network of aligned providers through ownership of implementation and provider relations functions. We step in as the care provider and care planner that work to keep our participants within their communities, out of institutions, and cared for like family, all while receiving the healthcare and social services needed to thrive.
ExpandApply NowActive JobUpdated 9 days ago
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