Provider Relations Representative

Catholic Health Services of Long Island - Garden City, NY (30+ days ago)3.1


Catholic Health Services of Long Island (CHS) is an integrated health care delivery system with some of the region's finest health and human services agencies. CHS includes six hospitals, three skilled nursing facilities, a regional home nursing service, hospice and a multiservice, community-based agency for persons with special needs. Under the sponsorship of the Diocese of Rockville Centre, CHS serves hundreds of thousands of Long Islanders each year, providing care that extends from the beginning of life to helping people live their final years in comfort, grace and dignity.

The Provider Relations Representative is responsible for assisting in the full range of provider relations and education interactions with providers in the CHS Physician Partner network. This person will be responsible for building relationships with network providers and office staff and supporting the practices with ongoing education and training on guidelines for all value based contracts.

Responsibilities:
Establish working relationships and collaborate with office staff in executing contracts and adhering to benchmarks set forth in all value based programs
Work together with providers and office staff to ensure compliance with Beacon's requirements and expectations
Perform site visits to conduct outreach, education, training and orientation sessions for providers and key administrative staff
Monitor practice performance to ensure compliance with all contractual agreements, identify any barriers and make recommendations for corrective action plans and other interventions as required
Review departmental and personal goals on an on-going basis with Director of Provider Relations
Follow all applicable federal/state regulations with respect to Confidentiality and HIPAA, among others
Mandatory attendance at quarterly membership meeting, monthly orientation seminars and monthly physician networking events which occur outside of regular business hours
Interact in a professional, respectful and helpful manner
Continue professional growth and development
Complete deliverables in a timely fashion
Generate call and visit reports daily and document all practice encounters

Requirements:
Bachelor's degree from an accredited university in Business Administration, Health Care Administration or other related field
Three to five years' experience preferred in a provider relations/customer service position
Excellent written and oral communication skills
Advanced knowledge of Microsoft Office
Strong organizational, problem solving and decision making skills
Ability to prioritize and manage multiple projects and issues effectively and simultaneously
Self-motivated and self-starter who can work well under minimal supervision
Strong attention to detail, research and follow up skills
Outstanding customer service and negotiation skills
Solid knowledge and understanding of managed care industry and various provider payment methodologies, including claims experience/knowledge of medical coding
Ability to work both independently and in a team setting
Valid driver's license and reliable insured automobile required. Must be able to travel locally up to 75% of the time
At Catholic Health Services of Long Island your well-being comes first, with comprehensive compensation and benefits; our offerings go beyond the basics. In addition to multiple medical plans, life insurance, generous paid time off and flexible spending accounts, we also offer substantial tuition reimbursement, an employer funded pension plan and several savings plan options for your future.