Top 4776 Provider Relations Representative Jobs

Provider Relations Representative (Remote in AZ - Pima or Pinal)
Imperial Management Administrators Services Inc —Arizona
- $30 - $32 an hour
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Marketing
Quick Apply
Provider Relations Representative
Key Family of Companies —Indianapolis, IN
- Full-time
- Remote
- Mid-level
- 3 years
- Analysis skills
- Health insurance
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Community Relations Representative-Atlanta,GA
Smooth Mooove Senior Relocation Services, Inc. —Remote
- From $55,000 a year
- Part-time
- Business development experience
- Driver's License
- Reliable transportation
- Opportunities for advancement
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Claims & Appeals Specialist II
Driscoll Health —Corpus Christi, TX
- Full-time
- Research
- Mid-level
- 3 years
Licensed Practical Nurse
UroHealth Partners —Omaha, NE
- Full-time
- Nursing
- Medical office experience
- BLS Certification
- Health savings account
- Health insurance
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Marketing Coordinator
Colonial House, Incorporated —York, PA
- From $19.25 an hour
- Part-time
- Computer literacy
- Mid-level
- Office
- Mileage reimbursement
- Tuition reimbursement
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Special Education Teacher - Grades TK-4
Pollock Pines Elementary School District —Pollock Pines, CA
- $55,703 - $100,171 a year
- Full-time
- Classroom
- Management
- Current TB test
- Health insurance
- Dental insurance
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Advanced Practice Provider (APP)
Memorial Health System —Springfield, IL
- Overtime
- CPR Certification
- Nursing
- RN License
- Relocation assistance
- Health insurance
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Chief Medical Officer (Physician)
K'ima:w Medical Center —Hoopa, CA
- $280,000 - $350,000 a year
- Full-time
- Background check
- CPR Certification
- Medicine
- Relocation assistance
- Health insurance
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Executive Director
Captiva Erosion Prevention District —Captiva, FL
- $120,000 - $130,000 a year
- Full-time
- Background check
- Office
- Administrative experience
- Health insurance
- Dental insurance
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Substance Abuse Counselor
Behavioral Health Group —Glen Allen, VA
- $23 an hour
- No nights
- LMFT
- Addiction Medicine
- Word processing
- Paid holidays
- Health insurance
NEI - Special Education Teacher with EL Endorsement
Noble Education Initiative, Inc. —Nashville, TN
- From $52,000 a year
- Full-time
- Background check
- Classroom
- Microsoft Excel
- Health savings account
- Health insurance
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VP, Operations
Freshpoint —Turlock, CA
- $122,300 - $203,900 a year
- Evenings as needed
- 7 years
- Sales
- Ability to walk for extended periods
Business Development Representative – Attorney Relations
RejuvenX —Fort Lauderdale, FL
- Full-time
- Background check
- Spanish
- Microsoft Excel
- Health insurance
- Dental insurance
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Vice President of Human Resources
Jackson College —Jackson, MI
- $160,000 - $180,000 a year
- Full-time
- Writing skills
- English
- Master's degree
- AD&D insurance
- Paid holidays
7d
Medical Marketing Representative
Injury Docs Now —Queens, NY
- $75,000 - $80,000 a year
- Full-time
- Clean driving record
- Microsoft Excel
- Microsoft Outlook
- Paid time off
Quick Apply
1d
Medical Laboratory Scientist , MLS II - Hematology Specialist, primarily day shift ~ Sign On Bonus
Northwestern Medical Center —Saint Albans, VT
- $31.04 - $45.27 an hour
- Weekends as needed
- Hospital
- Mid-level
- Bachelor's degree
Outside Sales Consultant
Bath Fitter —Allentown, PA
- Full-time
- Background check
- Clean driving record
- Customer service
- Health insurance
- Dental insurance
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NEI - Special Education Teacher
Noble Education Initiative, Inc. —Nashville, TN
- From $52,000 a year
- Full-time
- Background check
- Classroom
- Microsoft Excel
- Health insurance
- Dental insurance
Quick Apply
Dietary Manager
North Star Behavioral Health —Anchorage, AK
- From $31.70 an hour
- Full-time
- Background check
- ServSafe
- Computer literacy
- Disability insurance
- Health insurance
Quick Apply

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Provider Relations Representative (Remote in AZ - Pima or Pinal)

Imperial Management Administrators Services Inc -
Arizona

Quick Apply

Job Details

Full-time
$30 - $32 an hour

Qualifications

Customer communication
Microsoft Excel
Microsoft Outlook
English
Driver's License
Negotiating purchasing contracts

Full Job Description

Must reside in Arizona in either Pima or Pinal County.

JOB DESCRIPTION

JOB TITLE: Provider Network Administrator FLSA STATUS: Exempt

DEPARTMENT: Provide Network Management

REPORTS TO: Sr. Provider Network Administrator

JOB SUMMARY: Maintains a successful working relationship between Imperial Health Plans, network providers, and partner health plans through a full range of provider relations and service interactions to ensure network adequacy, and provider relations. Identify and communicate operational issues raised by providers, respond to customer complaints, customer satisfaction surveys and provider questions, and research and resolve accounts payable issues. Routinely negotiate cost effective fees for single services, confirm service capability and educate providers on contract expectations, processes, and paperwork. Comprehend detailed knowledge of Imperial’s requirements in order to adapt agreements, contractual requirements and fee agreements to the specific situation. Must be able to routinely evaluate and analyze the most beneficial solution for Imperial and our network providers in a variety of circumstances.

ESSENTIAL JOB FUNCTIONS:

1. Complete required Provider Office Face-to Face Visitation (daily, weekly, monthly) as assigned or predetermined by department management.

2. Assess and resolve specific provider concerns, developing and implementing solutions that are beneficial to providers, Imperial Members and Imperial.

3. Maintain network adequacy. Lead efforts to obtain letter of agreements as necessary.

4. Onboard new providers within 10 business days. Train providers on an annual basis.

5. Assess and respond to leads generated by brokers, providers, and customers.

6. Negotiate fees that align provider needs and Imperial business objectives. Educate providers on fee structures to ensure collaborative agreement and understanding of Imperial Services and the fees associated with them.

7. Staff Provider Relations Telephone Queue, adequately respond to and resolve incoming calls in the appropriate manner.

8. Respond to Customer Satisfaction Surveys and Customer Complaints within the required time frame through investigation and problem solving that results in positive outcomes.

9. Provide explanations and information to others on topics within area of expertise.

10. Proactively review and maintain provider compliance documents to ensure active status within provider network.

11. Collaborate with other departments to assign qualified providers to orders within the contractually allowed mileage radius of the patient's home zip code.

12. Maintains regular and consistent attendance.

13. Adheres to Compliance Plan and HIPAA regulations.

MARGINAL JOB FUNCTIONS:

1. Takes on special projects as needed.

2. Performs other duties as assigned.

BEHAVIORAL EXPECTATIONS:

1. Continuous Learning:

a. Attends staff meetings as required.

b. Attends appropriate training, seminars and workshops as required

2. Customer Focus:

a. Maintains client/customer confidentiality and privacy in accordance with HIPPA regulations and IMAS’s Standards of Conduct.

b. Fosters appropriate communication and relations with Supervisor, co-workers and other staff.

3. Quality/Process Improvement/Safety

a. Reports issues of security, health and/or safety to appropriate supervisor as soon as practicable.

b. Supports and demonstrates safety throughout all duties performed.

c. Follows established policies and procedures and understands and complies with all regulators standards set forth by governing entities.

POSITION REQUIREMENTS:

EDUCATION/EXPERIENCE:

 High school graduate or equivalent.

 Bachelor’s Degree (or higher) in Business, Marketing, Communications or healthcare related field

 3+ years of related experience in provider relations, network management, customer service, contract negotiations, account services and/or account management, etc. (or High School Diploma /

GED and 3+ years of related experience)

SKILLS/KNOWLEDGE/ABILITY:

 Must reside in the County where work is assigned

 Microsoft Office Suite (Word, Outlook, Excel

 Knowledge of negotiating rates and managing subcontractor relationships

 Knowledge of Medicare and Medical terminology (preferred)

 Willingness and ability to read, write, speak, understand English and have the communications skills necessary to provide accurate information to residents and staff.

 Willingness and ability to follow written and verbal direction in English.

 Willingness and ability to maintain appropriate level of confidentiality and privacy.

 Willingness and ability to interact professionally with all customers, members, and co-workers, individually and as part of a team.

 Willingness and ability to effectively handle multiple items/tasks as required and adapt favorably to changing priorities.

 Willingness and ability to make appropriate judgments, decisions and problem solving in a timely manner and within the context of the situation at hand.

 Ability to effectively prioritize items/tasks as required.

 Willingness and ability to take initiative and be a self-starter.

 Willingness and ability to understand and comply with Federal, State, and local regulations.

LICENSURE/CERTIFICATE/TRAINING:

 Driver’s License – must have reliable transportation with automobile insurance

Job Type: Full-time

Work Location: Remote

Quick Apply

Refine Your Search

Provider Relations Representative jobs

Provider Relations Representative (Remote in AZ - Pima or Pinal)

Provider Relations Representative

Community Relations Representative-Atlanta,GA

Claims & Appeals Specialist II

Licensed Practical Nurse

Marketing Coordinator

Special Education Teacher - Grades TK-4

Advanced Practice Provider (APP)

Chief Medical Officer (Physician)

Executive Director

Substance Abuse Counselor

NEI - Special Education Teacher with EL Endorsement

VP, Operations

Business Development Representative – Attorney Relations

Vice President of Human Resources

Medical Marketing Representative

Medical Laboratory Scientist , MLS II - Hematology Specialist, primarily day shift ~ Sign On Bonus

Outside Sales Consultant

NEI - Special Education Teacher

Dietary Manager

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