Top 6 Provider relations Jobs in Charlotte, Nc

Health Plan Provider Relations Representative
Molina Healthcare —Rock Hill, SC
- $18.85 - $38.69 an hour
- Full-time
- Medical office experience
- Mid-level
- Training & development
- Health insurance
11d
Provider Relations
The Treetop ABA Therapy —Charlotte, NC
- $70,000 - $200,000 a year
- Full-time
- Hybrid work
- Applied behavior analysis
- Mid-level
- Driving
- Paid holidays
- Health insurance
Quick Apply
Physician Liaison
Alpaca Health —Charlotte, NC
- $70,000 - $100,000 a year
- Full-time
- Hybrid work
- Research
- Mid-level
- Health insurance
- Paid time off
Quick Apply
Outreach/ Physician Liaison- Part Time
Circle Care Services —Charlotte, NC
- $30 - $40 an hour
- Part-time
- Hybrid work
- Mid-level
- Driver's License
- Children
- Mileage reimbursement
Quick Apply
14d
Physician Liaison / Community Outreach Coordinator-Hourly + Performance Bonuses
Best Life Mental Health & Wellness PLLC —Cornelius, NC
- $22 - $28 an hour
- Part-time
- Sales
- Medical office experience
- Adults
- Flexible schedule
Quick Apply
Physician Liaison
CORA Physical Therapy —Harrisburg, NC
- $60,000 - $70,000 a year
- Full-time
- Driver's License
- Presentation skills
- Smartphone
- Paid holidays
- Disability insurance
Quick Apply

Discover related jobs

Based on your search for provider relations jobs.

School Age Program Manager
Carolina Kids Child Development Center —Rock Hill, SC
50% childcare tuition discount—a huge perk for your own little learners! Mentor teachers with hands-on assessments, trainings, and onboarding to help them shine…
$40,000 - $43,000 a year
6d
Program Manager/Training Lead
Contact Government Services, LLC —Charlotte, NC
Ability to design and develop comprehensive training approach, curriculum, and materials, including manuals, tutorials, and e-learning modules.
$180,000 - $200,000 a year
Quick Apply

Show more related jobs

Explore jobs in cities nearby

Check out jobs in cities near your current location, Columbus

Provider Relations Representative
Key Family of Companies —Columbus, OH
The Provider Relations Representative will be responsible for the strategic direction, while maintaining successful oversight of all network relationships,…
Quick Apply
Physician Liaison
Bierman Autism Centers —Dublin, OH
Bachelor’s degree in healthcare administration, marketing, business, childhood development, or related field. Collaborate with intake, clinical, and operations…
$80,000 - $90,000 a year
Quick Apply

I want to receive the latest job alert for provider relations in charlotte, nc

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

provider relations jobs near charlotte, nc

Health Plan Provider Relations Representative

Molina Healthcare -
Rock Hill, SC

Apply Now

Job Details

Full-time
$18.85 - $38.69 an hour
11 days ago

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

_*Remote and must live in South Carolina*_

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.
Role requires 60%+ same-day or overnight travel (extent of same-day or overnight travel will depend on the specific health plan service area).

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: $18.85 - $38.69 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply Now

Refine Your Search

provider relations jobs in charlotte, nc

Health Plan Provider Relations Representative

Provider Relations

Physician Liaison

Outreach/ Physician Liaison- Part Time

Physician Liaison / Community Outreach Coordinator-Hourly + Performance Bonuses

Physician Liaison

Discover related jobs

Explore jobs in cities nearby

I want to receive the latest job alert for provider relations in charlotte, nc

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected