Top 1802 Consumer relations representative Jobs

Representative, Health Plan Provider Relations - Remote Must reside in NY
Molina Healthcare —New York, NY
- $19.84 - $46.42 an hour
- Full-time
- Remote
- Medical office experience
- Mid-level
- Travel
- Health insurance
School Enrollment & Marketing Admin
Sarasota Classical Preparatory Academy —Sarasota, FL
- Overtime
- Bilingual
- Background check
- School experience
Speech Language Pathologist
MINDS MATTER LLC —Topeka, KS
- $42 - $50 an hour
- Contract
- Experience working with individuals with disabilities
- Mid-level
- Communication skills
Quick Apply
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HR Generalist - 1st and 2nd Shift (Associate Relations Representative)
Perdue Farms, Inc. —Bridgewater, VA
- $68,000 - $90,000 a year
- Full-time
- Background check
- Spanish
- Employment & labor law
- Paid jury duty
- Health savings account
Quick Apply
Physical Therapist
MINDS MATTER LLC —Chesterfield, MO
- $50 an hour
- Contract
- Physical & Rehabilitation Medicine
- Mid-level
- Physical Therapy License
Quick Apply
10d
Trust Officer
COREFIRST BANK & TRUST —Topeka, KS
- Evenings as needed
- Microsoft Excel
- Microsoft Outlook
- CPA
- Life insurance
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
12d
Outside Sales Consultant
Bath Fitter —Altoona, PA
- Full-time
- Background check
- Clean driving record
- Customer service
- Health insurance
- Dental insurance
Quick Apply
Assistant Manager - Final Mile Delivery
Pillar Logistics —Westwood, MA
- $55,000 - $65,000 a year
- Full-time
- Mid-level
- Office
- Mentoring
Quick Apply
Branch Manager (Bilingual)
World Finance Company of Oklahoma, LLC —Stilwell, OK
- $38,000 - $42,000 a year
- Extended hours
- Spanish
- Word processing
- English
Quick Apply
4d
Sales Account Manager
Wittenbach Business Systems LLC —Charleston, SC
- Full-time
- Clean driving record
- Marketing
- Mid-level
- Paid training
- Health savings account
Quick Apply
Outside Sales Consultant
Bath Fitter —Peoria, IL
- Full-time
- Background check
- Clean driving record
- Customer service
- Health insurance
- Dental insurance
Quick Apply
Registered Nurse Emergency Services
Frisbie Memorial Hospital —Rochester, NH
- Full-time
- Mid-level
- Pediatrics
- Employee stock purchase plan
- Disability insurance
Quick Apply
Jr Sales Representative
RCG Consultants —Raleigh, NC
- $800 - $1,200 a week
- Full-time
- High school diploma or GED
- Presentation skills
- Entry level
- Opportunities for advancement
Quick Apply
5d
Electrical Maintenance Technician
Minerals Technologies —Canaan, CT
- $34.99 - $48.78 an hour
- 8 hour shift
- English
- Mid-level
- 3 years
- Disability insurance
- Health insurance
Member Service Representative
Grand Altitude Federal Credit Union —Lander, WY
- From $19 an hour
- 8 hour shift
- Background check
- Customer service
- Basic math
- Health insurance
- Dental insurance
Quick Apply
5d
Senior Center Program Coordinator
Boyertown Area Multi-Service —Boyertown, PA
- $16 - $20 an hour
- Weekends as needed
- Microsoft Excel
- Microsoft Outlook
- Mid-level
Quick Apply
Sales Representative
MariMed —Boston, MA
- $60,000 - $80,000 a year
- Weekends as needed
- Background check
- Sales
- Merchandising
- Health insurance
- Dental insurance
Quick Apply
Personal Banker/Lead Customer Service Representative
Peoples Bank —Akron, IA
- Full-time
- Mid-level
- Office
- 3 years
Sales Representative – Biotech (Entry)
Immune Biopharma —California
- $88,556 - $118,356 a year
- Online Application
- No travel
- Leadership
- Communication skills
Quick Apply

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Representative, Health Plan Provider Relations - Remote Must reside in NY

Molina Healthcare -
New York, NY

Apply Now

Job Details

Full-time
$19.84 - $46.42 an hour

Benefits

Health insurance

Qualifications

Customer communication
Managed care
Managed care organization experience
Medical office experience
Schedule management
Health insurance knowledge
Productivity software
Cross-functional collaboration
Cross-functional communication

Full Job Description

JOB DESCRIPTION Job Summary

Provides support for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers within the Molina network. Responsible for network management including provider education, communication, satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina policies and procedures.

Essential Job Duties

Successfully engages high-volume, high-visibility plan providers, to ensure provider satisfaction, facilitate education on key Molina initiatives, and improve coordination and partnership between the health plan and contracted providers.
Serves as the primary point of contact between Molina health plan and the non-complex provider community that services Molina members, including but not limited to fee-for-service (FFS) and pay-for-performance (P4P) providers.
Collaborates directly with the plan’s external providers to educate, advocate and engage as valuable partners - ensuring knowledge of and compliance with Molina policies and procedures while achieving the highest level of customer service; effectively drives timely issue resolution, electronic medical record (EMR) connectivity, and provider portal adoption.
Conducts regular provider site visits within assigned region/service area; determines daily or weekly schedule, to meet or exceed the plan's monthly site visit goals. Proactively engages with the provider and staff to determine; for example, non-compliance with Molina policies/procedures or Centers for Medicare and Medicaid Services (CMS) guidelines/regulations, or to assess the non-clinical quality of customer service provided to Molina members.
Provides on-the-spot training and education as needed, including counseling providers diplomatically, while retaining a positive working relationship.
Independently troubleshoots provider problems as they arise, and takes initiative in preventing and resolving issues between the provider and the plan whenever possible. The types of questions, issues or problems that may emerge during visits are unpredictable and may range from simple to very complex or sensitive matters.
Initiates, coordinates and participates in problem-solving meetings between the provider and Molina stakeholders, including senior leadership and physicians (examples include: issues related to utilization management, pharmacy, quality of care, and correct coding).
Independently delivers training and presentations to assigned providers and their staff - answering questions that come up on behalf of the health plan; may also deliver training and presentations to larger groups, such as leaders and management of provider offices, including large multispecialty groups or health systems, executive level decision makers, association meetings, and joint operating committees (JOCs).
Performs an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives; examples of such initiatives include: administrative cost-effectiveness, member satisfaction - Consumer Assessment of Healthcare Providers and Systems (CAHPS), regulatory-related, Molina quality programs, and taking advantage of electronic solutions (electronic data interchange (EDI), EMR, provider portal, provider website, etc.).
May provide training and support to new and existing provider relations team members as appropriate.

will require to travel at least once a week subject to change.

Required Qualifications

At least 2 years of customer service, provider services, or claims experience in a managed care or medical office setting, or equivalent combination of relevant education and experience.
General understanding of the health care delivery system, including government-sponsored health plans.
Organizational skills and attention to detail.
Ability to manage multiple tasks and deadlines effectively.
Interpersonal skills, including ability to interface with providers and medical office staff.
Ability to work in a cross-functional highly matrixed organization.
Effective verbal and written communication skills.
Microsoft Office suite and applicable software programs proficiency.

Preferred Qualifications

Familiarity with various managed health care provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including: fee-for service (FFS), capitation and various forms of risk, ASO, etc.
Experience delivering training and facilitating educational presentations.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $19.84 - $46.42 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply Now

Refine Your Search

consumer relations representative jobs

Representative, Health Plan Provider Relations - Remote Must reside in NY

School Enrollment & Marketing Admin

Speech Language Pathologist

HR Generalist - 1st and 2nd Shift (Associate Relations Representative)

Physical Therapist

Trust Officer

Business Development Representative -FMO Health Insurance

Outside Sales Consultant

Assistant Manager - Final Mile Delivery

Branch Manager (Bilingual)

Sales Account Manager

Outside Sales Consultant

Registered Nurse Emergency Services

Jr Sales Representative

Electrical Maintenance Technician

Member Service Representative

Senior Center Program Coordinator

Sales Representative

Personal Banker/Lead Customer Service Representative

Sales Representative – Biotech (Entry)

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