Top 129 Senior representative Jobs in Columbia, Sc

Health Plan Provider Relations Representative
Molina Healthcare —Columbia, SC
- $18.85 - $38.69 an hour
- Full-time
- Medical office experience
- Mid-level
- Training & development
- Health insurance
8d
Senior Manager Finance - REMOTE
Ryder System —Columbia, SC
- $110,000 - $130,000 a year
- Full-time
- Remote
- Microsoft Excel
- Finance
- 8 years
- Disability insurance
- Health insurance
8d
Inbound Sales Representative (Remote/Eastern Time)
A Place for Mom —Columbia, SC
- $45,760 a year
- Weekends as needed
- Remote
- Microsoft Word
- Mid-level
- US work authorization
- Health insurance
- Dental insurance
Quick Apply
Director, HR & Labor Relations
The Nuclear Company —Columbia, SC
- $178,000 - $204,000 a year
- Master's degree
- Bachelor's degree
- Continuous improvement
- Health insurance
- Dental insurance
Senior Customer Service Representative
Sydnic LLC —Columbia, SC
- $24 - $28 an hour
- Full-time
- Google Workspace
- Microsoft Excel
- Microsoft Outlook
- Travel reimbursement
- Health savings account
Quick Apply
Director of Eligibility
State of South Carolina —Lexington County, SC
- $79,600 - $111,500 a year
- Full-time
- LMFT
- Current TB test
- Pass drug screening
- Paid parental leave
- Paid holidays
Telephonic Case Manager I - Columbia, SC
CorVel Corporation —Columbia, SC
- $63,739 - $95,264 a year
- Full-time
- Remote
- Nursing
- RN License
- Computer literacy
- Health savings account
- Disability insurance
Quick Apply
Finance Segment Manager - REMOTE
Ryder System —Columbia, SC
- $100,000 - $105,000 a year
- Full-time
- Remote
- Microsoft Word
- Inventory management
- 5 years
- Disability insurance
- Health insurance
13d
Columbia, SC based Clinical Specialist - Remote, USA
Calyxo —Columbia, SC
- $80,000 - $140,000 a year
- Nursing
- Surgery
- Sales
- Health insurance
- 401(k)
Quick Apply
13d
Senior Sales & Service Representative (Universal Banker)
First Citizens Bank —Lexington, SC
- Full-time
- Mid-level
- Office
- High school diploma or GED
Life Insurance Sales Team Manager
Kronos Financial —Columbia, SC
- $84,000 - $162,000 a year
- Weekends as needed
- Bilingual
- Background check
- Sales
Quick Apply
1d
Senior Operations Manager - Warehouse
Ryder System —Columbia, SC
- $95,000 - $100,000 a year
- Urgently hiring
- 5 years
- Master's degree
- High school diploma or GED
- Paid parental leave
- Paid holidays
Licensed Practical Nurse I PT PRN
Wildewood Downs —Columbia, SC
- $27.94 an hour
- Part-time
- CPR Certification
- Vital signs
- BLS Certification
Quick Apply
Senior Program Associate & Facilitator
Impact Justice —Columbia, SC
- $34.68 an hour
- Part-time
- Hybrid work
- Classroom
- Continuous improvement
- Senior level
- Health insurance
- Dental insurance
Quick Apply
Structural Project Manager
Parsons —Columbia, SC
- $125,100 - $225,200 a year
- Hybrid work
- Bachelor's degree
- Senior level
- Professional Engineer
- Wellness program
- Paid holidays
Construction Project Management Corporate Fellowship - Hiring Our Heroes- REMOTE
Ryder System —Columbia, SC
- $70,000 - $90,000 a year
- Full-time
- Remote
- Military
- 3 years
- Finance
- Disability insurance
- Health insurance
Fuel Program Manager
Westinghouse Electric Company —Hopkins, SC
- $103,200 - $129,000 a year
- Hybrid work
- Mid-level
- 3 years
- Bachelor's degree
- Health savings account
- Paid holidays
Senior Materials Manager
Trane Technologies —Columbia, SC
- $113,810 - $183,400 a year
- Full-time
- 5 years
- Pass drug screening
- Bachelor's degree
- Paid holidays
- Health insurance
Senior Field Service Technician
Ricoh —Columbia, SC
- Overtime
- Office
- 3 years
- Ability to lift 50 pounds
Resource Development Director- Boys & Girls Clubs of the Crescent Region
Boys & Girls Club Crescent Region —Columbia, SC
- From $85,000 a year
- Weekends as needed
- Hybrid work
- Clean driving record
- Sales
- Analysis skills
Quick Apply

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Health Plan Provider Relations Representative

Molina Healthcare -
Columbia, SC

Apply Now

Job Details

Full-time
$18.85 - $38.69 an hour
8 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

senior representative jobs in columbia, sc

Health Plan Provider Relations Representative

Senior Manager Finance - REMOTE

Inbound Sales Representative (Remote/Eastern Time)

Director, HR & Labor Relations

Senior Customer Service Representative

Director of Eligibility

Telephonic Case Manager I - Columbia, SC

Finance Segment Manager - REMOTE

Columbia, SC based Clinical Specialist - Remote, USA

Senior Sales & Service Representative (Universal Banker)

Life Insurance Sales Team Manager

Senior Operations Manager - Warehouse

Licensed Practical Nurse I PT PRN

Senior Program Associate & Facilitator

Structural Project Manager

Construction Project Management Corporate Fellowship - Hiring Our Heroes- REMOTE

Fuel Program Manager

Senior Materials Manager

Senior Field Service Technician

Resource Development Director- Boys & Girls Clubs of the Crescent Region

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