Top 2795 Physician 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
Assistant Chief Nursing Officer
Helena East of Cascadia LLC —Helena, MT
- $45 - $55 an hour
- Full-time
- CPR Certification
- Nursing
- Skilled nursing facility
Quick Apply
Physician
K'ima:w Medical Center —Hoopa, CA
- $310,000 - $340,000 a year
- Full-time
- Acute care
- CPR Certification
- Medicine
- Relocation assistance
- Health insurance
Quick Apply
Radiology Technologist- Pain Management Clinic
WVUH West Virginia University Hospitals —Morgantown, WV
- Full-time
- Anatomy knowledge
- BLS Certification
- No experience needed
Radiology Technologist
WVUH West Virginia University Hospitals —Morgantown, WV
- Full-time
- Anatomy knowledge
- No experience needed
- Mid-level
Staff Physician MD/DO, Primary Care Gallup, New Mexico SIGN-ON BONUS
Duke City Urgent Care —Gallup, NM
- $250,000 - $300,000 a year
- Part-time
- CPR Certification
- Medicine
- PALS Certification
- Health insurance
- Dental insurance
Quick Apply
14d
Physician- OB/GYN
Matrix Providers —Fort Carson, CO
- $159.60 - $168.00 an hour
- Full-time
- Surgery
- Ob/Gyn
- Perioperative Care
Quick Apply
Licensed Practical Nurse
UroHealth Partners —Omaha, NE
- Full-time
- Nursing
- Medical office experience
- BLS Certification
- Health savings account
- Health insurance
Quick Apply
House Supv RN Access Center - Day Shift
Driscoll Health —Corpus Christi, TX
- Weekends as needed
- CPR Certification
- Nursing
- RN License
PRN - Pain Management- ICC Ambulatory Surgery Center
KU MedWest Ambulatory Surgery Center, LLC —Overland Park, KS
- Part-time
- Nursing
- Surgery
- RN License
Quick Apply
RN-Float- 11a-11p (Full-time)
Shenandoah Valley Westminster Canterbury —Winchester, VA
- $33.46 - $48.10 an hour
- Full-time
- CPR Certification
- RN License
- Ability to walk for extended periods
Quick Apply
Radiology Technologist (Full Time)
Uniontown Hospital —Uniontown, PA
- $10,000 - $12,500 a year
- Full-time
- Acute care
- Anatomy knowledge
- No experience needed
Wellness Director/Director of Nursing LPN
The Residence at Whitehall —Pittsburgh, PA
- From $75,000 a year
- On call
- Nursing
- English
- Mid-level
- Wellness program
- Paid holidays
Quick Apply
CT Technologist
Corazon Imaging —Waterford, MI
- $36 - $42 an hour
- Per diem
- Patient monitoring
- Writing skills
- BLS Certification
Quick Apply
RN Clinical Liaison (Hospice) Part Time - Lancaster, PA
CONSTELLATION HEALTH SERVICES —Lancaster, PA
- $36,000 a year
- Full-time
- CPR Certification
- Nursing
- Management
Quick Apply
Director of Nursing
Norwich Rehabilitation & Nursing Center —Norwich, NY
- $120,000 - $125,000 a year
- Overtime
- CPR Certification
- Nursing
- RN License
- Health insurance
- Dental insurance
Quick Apply
Registered Respiratory Therapist
Memorial Health —Decatur, IL
- $34.34 - $53.23 an hour
- Full-time
- CPR Certification
- Hospital
- BLS Certification
Mammography Technologist
Uniontown Hospital —Uniontown, PA
- Full-time
- Hospital
- BLS Certification
- No experience needed
RN - Full Time
Vetras Healthcare LLC —Torrington, WY
- 12 hour shift
- Nursing
- RN License
- Writing skills
Quick Apply
Director Of Outpatient Quality, Network Administration, Full-Time, Days
MarinHealth Medical Network —Novato, CA
- $182,728 - $219,273 a year
- 8 hour shift
- Nursing
- RN License
- Analysis skills
Quick Apply

I want to receive the latest job alert for physician relations representative

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

physician relations representative jobs near

Pain Management Physician jobs in Overland Park, KS

Respiratory Therapist jobs in Decatur, IL

Radiologic Technologist jobs in Uniontown, PA

Registered Nurse jobs in Winchester, VA

Health Care Provider jobs in New York, NY

Chief Nursing Officer jobs in Helena, MT

Wellness Nurse jobs in Pittsburgh, PA

Primary Care Physician jobs in Gallup, NM

Mammography Technologist jobs in Uniontown, PA

Licensed Practical Nurse jobs in Omaha, NE

Hospice Nurse jobs in Lancaster, PA

Director Of Nursing jobs in Norwich, NY

Radiologic Technologist jobs in Morgantown, WV

Pain Management Physician jobs in San Pablo, CA

Psychiatric Physician Assistant jobs in Ohio

Pain Management Physician jobs in San Antonio, TX

Pain Management Physician jobs in California

Pediatric Physician Assistant jobs in Boston, MA

Pain Management Physician jobs in Spring, TX

Respiratory Therapist jobs in Lahore, VA

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

physician relations representative jobs

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

Assistant Chief Nursing Officer

Physician

Radiology Technologist- Pain Management Clinic

Radiology Technologist

Staff Physician MD/DO, Primary Care Gallup, New Mexico SIGN-ON BONUS

Physician- OB/GYN

Licensed Practical Nurse

House Supv RN Access Center - Day Shift

PRN - Pain Management- ICC Ambulatory Surgery Center

RN-Float- 11a-11p (Full-time)

Radiology Technologist (Full Time)

Wellness Director/Director of Nursing LPN

CT Technologist

RN Clinical Liaison (Hospice) Part Time - Lancaster, PA

Director of Nursing

Registered Respiratory Therapist

Mammography Technologist

RN - Full Time

Director Of Outpatient Quality, Network Administration, Full-Time, Days

I want to receive the latest job alert for physician relations representative

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected