Top 533 Employee Relations Rep Jobs

Medicaid Provider Relations Rep II
Moda Health —Portland, OR
- $54,668.32 - $68,340.67 a year
- Full-time
- Hybrid work
- Microsoft Excel
- Research
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
Project Coordinator- Architectural Products
MDC Interior Solutions —Glendale Heights, IL
- $45,000 - $60,000 a year
- Full-time
- Microsoft Word
- Background check
- Microsoft Excel
- AD&D insurance
- Disability insurance
Quick Apply
7d
Ophthalmic Technician
Northwest Eye Center —Barrington, IL
- $22 - $27 an hour
- Multiple hires
- Sales
- Mid-level
- High school diploma or GED
- Profit sharing
- Paid holidays
Quick Apply
Director of Human Resources
Asolo Repertory Theatre —Sarasota, FL
- $75,000 - $80,000 a year
- Full-time
- Background check
- 5 years
- Research
- Health savings account
- Paid holidays
Quick Apply
Regional Safety and Environmental Rep
HOLT CAT —Irving, TX
- Full-time
- 5 years
- Mid-level
- CDL
Quick Apply
Hospice Account Executive/ Outside Sales
Unity Hospice —St. Louis, MO
- $60,000 - $70,000 a year
- Full-time
- Mid-level
- Driver's License
- Driving
- Paid holidays
- Health insurance
Quick Apply
Fire Alarm Sales Rep - Concord, NC
WAYNE AUTOMATIC FIRE SPRINKLERS INC —Concord, NC
- Full-time
- Background check
- Clean driving record
- Pass drug screening
- Paid holidays
- Disability insurance
Quick Apply
Autonomous Vehicle Roadside Assistance Agent
TaskUs —Novi, MI
- From $25 an hour
- 8 hour shift
- Background check
- Clean driving record
- Software troubleshooting
- Paid training
- Disability insurance
2d
Business Development Representative -FMO Health Insurance
Alliant Insurance Services —Fort Lauderdale, FL
- $60,000 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Marketing
Quick Apply
8d
Accounts Payable/Rep Payee/Benefits Analyst FEA
AssuranceSD —Taylor, MI
- Full-time
- Background check
- Microsoft Excel
- Customer service
- Health savings account
- Paid holidays
Quick Apply
Autonomous Vehicle Roadside Assistance Agent
TaskUs —Baltimore, MD
- From $23 an hour
- 8 hour shift
- Background check
- Clean driving record
- Customer service
- Disability insurance
- Health insurance
2d
Hospice Account Executive/ Outside Sales
Unity Hospice —Collinsville, IL
- $60,000 - $70,000 a year
- Full-time
- Mid-level
- Driver's License
- Driving
- Paid holidays
- Health insurance
Quick Apply
Senior Clinical Scheduling Coordinator
National Jewish Health —Denver, CO
- $20.69 - $27.36 an hour
- Full-time
- Hospital
- Word processing
- Mid-level
- Wellness program
- Health savings account
Outside Sales Representative
Nippon Trends —San Jose, CA
- $70,500 - $72,000 a year
- Weekends as needed
- Microsoft Word
- Microsoft Excel
- Sales
- Health insurance
- Dental insurance
Quick Apply
Autonomous Vehicle Roadside Assistance Agent
TaskUs —Novi, MI
- From $25 an hour
- 8 hour shift
- Background check
- Pass drug screening
- 3 years
- Paid training
- Health insurance
Quick Apply
10d
Jr. Sales Associate - Austin
Burnett Specialists —Austin, TX
- $47,500 a year
- Urgently hiring
- Clean driving record
- Microsoft Outlook
- Writing skills
- Paid holidays
- Dental insurance
Quick Apply
Client Relationship Manager - Wholesale
Weston Nurseries —Hopkinton, MA
- $70,000 - $90,000 a year
- Full-time
- Mid-level
- In-person
- Communication skills
- Health insurance
- Dental insurance
Quick Apply
HVAC Production Project Manager
Advanced Air Systems —Fort Lauderdale, FL
- $75,000 - $95,000 a year
- Full-time
- 18 years or older
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply
Autonomous Vehicle Support Specialist
TaskUs —Novi, MI
- From $23 an hour
- 8 hour shift
- Background check
- Customer service
- Pass drug screening
- Paid training
- Disability insurance
Quick Apply
10d
Executive Assistant/Business Office Manager
Confidential —Natick, MA
- $27 an hour
- Full-time
- Background check
- Writing skills
- HIPAA
- Health savings account
- Health insurance
Quick Apply

I want to receive the latest job alert for Employee Relations Rep

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

Employee Relations Rep jobs near

Business Development Representative jobs in Fort Lauderdale, FL

Outside Sales Representative jobs in St. Louis, MO

Scheduling Coordinator jobs in Denver, CO

Outside Sales Representative jobs in San Jose, CA

Sales Representative jobs in Concord, NC

Customer Relations Representative jobs in Portland, OR

Director Of Human Resources jobs in Sarasota, FL

Ophthalmic Technician jobs in Barrington, IL

Vehicle Care Representative jobs in Baltimore, MD

Lvn Case Manager jobs in Los Angeles, CA

Hr Manager jobs in Detroit, MI

Business Development Representative jobs in Charleston, SC

Healthcare Customer Service Representative jobs in San Antonio, TX

Business Development Representative jobs in Miami, FL

Business Development Representative jobs in Mountain View, CA

Beauty Product Development Coordinator jobs in New York, NY

Remote Small Business jobs in California

Business Teacher jobs in Houston, TX

Business Development Representative jobs in Quincy, MA

Project Manager jobs in Baton Rouge, LA

Medicaid Provider Relations Rep II

Moda Health -
Portland, OR

Quick Apply

Job Details

Full-time
$54,668.32 - $68,340.67 a year

Benefits

Paid holidays
Health insurance
Dental insurance
Flexible spending account
Paid time off
Employee assistance program
Vision insurance
401(k) matching

Qualifications

Contract documentation review
Customer communication
Contract review
Microsoft Excel
Provider enrollment for medical credentialing
Contract interpretation
Contract management experience in healthcare
Medicaid health insurance
Check payment processing
Health policy
Data interpretation
Healthcare provider information
Conducting training sessions
Meeting facilitation
Networking through strategic partnership building
Medicaid regulations
Medicaid
Productivity software
Data validation
Strategic partnerships
Healthcare reimbursement methods
DRG

Full Job Description

Let’s do great things, together!

About Moda
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.

Position Summary
This position provides concierge customer service to providers by being the liaison between the Medicaid plans. The Provider Relations Representative is responsible for presenting, promoting, and resolving concerns and issues brought forward by providers and internal staff and develop, improve, and streamline existing provider policies with the goal of removing barriers to providing care. This role will also implement projects and policies that impact providers (includes drafting communications, frequently asked questions, resource guides) to support network needs and promote strong, collaborative relationships. This role will also plan, prepare, and develop training materials for contracted providers and will conduct face-to-face trainings throughout the year. Internally, this role will work closely with our Lead Medicaid Provider Relations Representative for other Medicaid lines of business, multiple departments and is a critical role in supporting daily operations. This is a FT hybrid position based in Portland, Oregon.

Pay Range
$54,668.32 - $68,340.67 salary (depending on experience). Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.

Please fill out an application on our company page, linked below, to be considered for this position.

https://j.brt.mv/jb.do?reqGK=27775587&refresh=true

Benefits:

Medical, Dental, Vision, Pharmacy, Life, & Disability
401K- Matching
FSA
Employee Assistance Program
PTO and Company Paid Holidays

Required Skills, Experience & Education:

Three or more years of provider relations experience.

Requires expertise in industry practices, specialized payment methodologies, Value Based Care agreements, Payer/Provider Strategic Partnerships, and all relevant regulations.

College degree in health care, business, analytics, or related field, or equivalent work experience.

Knowledge of Medicaid claims and benefits.

Proficient in identifying and interpreting Oregon Administrative Rules, CCO and provider contracts

Knowledge of provider payment methodologies including capitation, DRG, CAH and other facility and professional pricing.

Ability to analyze and validate provider claims and payment data.

Experience in manual processing of high dollar checks.

Judgement, self-motivation, and the ability to work independently, and as part of a team.

Is detail oriented and possess strong analytical, and problem-solving skills.

Skilled at delivering trainings and facilitating meetings.

Strong interpersonal communication skills and the ability to develop effective relationship with

network providers, members, and partners.

Proficiency in Microsoft Word, Excel, and PowerPoint.

Ability to work well under pressure with frequent interruptions and shifting priorities.

Must be willing to travel for provider training sessions.

Knowledge of Oregon’s Coordinated Care Organization (CCO) Infrastructure.

Must be able to represent the organizations at outside meetings, conferences, and events in a positive

and professional manner.

Must maintain confidentiality and project a professional business image.

Preferred Skills, Experience & Education:

Knowledge of medical office workflows.

Knowledge of other Moda Health products, plans, and networks.

Primary Functions:

Assist leadership in negotiating Single Case Agreements; review contract terms to ensure they can be operationalized.

Validation of bi-annual Delivery System Network (DSN) Report in partnership with analytics.

Assists with state, federal and other entity related audits.

Contract configuration, implementation, validation, and assessment.

Implement and coordinate new Medicaid provider focused initiatives.

Identify root causes of claim problems and trends and participate in developing solutions. This includes performing research through available systems, policies, and departments, ensuring timely resolution is achieved.

Work in a consultative role with various departments creating effective processes and updates.

Review and update Medicaid provider manuals, policies and procedures as well as desk manuals.

Oversight and management of Medicaid provider webpage content.

Utilize best practice policies and procedures, work guides or tools to provide improved department process workflows.

Coordinate and participate in targeted provider meetings, including annual Provider Workshops.

Educate providers on Oregon Administrative Rules and contract language ensuring consistent interpretation.

Provide timely responses to all provider inquiries, within two to three business days.

Provides ongoing support to the Medicaid Operations team.

Process provider enrollment applications and meet timelines established by management.

Complete and validate Medicaid encounter data.

Conduct on-site provider visits to create strategic provider partnerships to improve health efficiencies, and foster provider experience.

Attend State and other Medicaid related meetings to learn about new policy and initiative changes that have an impact on operations.

Perform other duties and special projects assigned.

Working Conditions & Contact with Others

Position is hybrid, based in Portland Oregon. Extensive close PC and keyboard work. Occasional require travel to off-site meetings which may include overnight stays.
Internally with multiple departments. Externally with providers, providers staff, office administrators, external partners, Oregon Health Authority staff.

Together, we can be more. We can be better.

Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training.

For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our [email protected] email.

Quick Apply

Refine Your Search

Employee Relations Rep jobs

Medicaid Provider Relations Rep II

Project Coordinator- Architectural Products

Ophthalmic Technician

Director of Human Resources

Regional Safety and Environmental Rep

Hospice Account Executive/ Outside Sales

Fire Alarm Sales Rep - Concord, NC

Autonomous Vehicle Roadside Assistance Agent

Business Development Representative -FMO Health Insurance

Accounts Payable/Rep Payee/Benefits Analyst FEA

Autonomous Vehicle Roadside Assistance Agent

Hospice Account Executive/ Outside Sales

Senior Clinical Scheduling Coordinator

Outside Sales Representative

Autonomous Vehicle Roadside Assistance Agent

Jr. Sales Associate - Austin

Client Relationship Manager - Wholesale

HVAC Production Project Manager

Autonomous Vehicle Support Specialist

Executive Assistant/Business Office Manager

I want to receive the latest job alert for Employee Relations Rep

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected