Top 68 Provider relations Jobs in Florida

Health Plan Provider Relations Manager (North Central Florida)
Molina Healthcare —Jacksonville, FL
- $60,415 - $117,809 a year
- Full-time
- 6 years
- Mid-level
- Presentation skills
- Health insurance
7d
Senior Project Manager, Provider Engagement Enablement
CVS Health —Florida
- $67,900 - $182,549 a year
- Full-time
- Remote
- 3 years
- Analysis skills
- Bachelor's degree
- Health insurance
- Dental insurance
14d
Senior Provider Relations Advocate - Miami, FL - Bilingual Spanish Required
UnitedHealthcare —Miami, FL
- $72,800 - $130,000 a year
- Full-time
- Microsoft Word
- Spanish
- Microsoft Access
Provider Contracting Professional (Dental Network)
Humana —Florida
- $65,000 - $88,600 a year
- Full-time
- Remote
- Research
- Mid-level
- Master's degree
- Travel reimbursement
- Paid parental leave
13d
Rep, Hospital Provider Relations HP
Molina Healthcare —Tampa, FL
- $19.84 - $38.69 an hour
- Full-time
- Medical office experience
- Mid-level
- Training & development
- Health insurance
Health Plan Provider Relations Manager (North Central Florida)
Molina Healthcare, Inc. —Perry, FL
- $60,415 - $117,809 a year
- Full-time
- 6 years
- Mid-level
- Presentation skills
- Health insurance
1d
Provider Relations Specialist
AVO T&L, LLC —Cocoa, FL
- Mid-level
- Communication skills
- Opportunities for advancement
Quick Apply
Network Relations Manager – Florida
CVS Health —Florida
- $60,300 - $132,600 a year
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- 3 years
- Health insurance
- Dental insurance
Sr. Provider Relations Representative
CLAREMEDICA HEALTH PARTNERS LLC —Miami Lakes, FL
- Spanish
- English
- Ability to climb stairs
Quick Apply
Director, Provider Relations
Independent Living Systems —Miami, FL
- Full-time
- 5 years
- Master's degree
- Bachelor's degree
Quick Apply
2d
Provider Network Relations Quality Specialist
Acuity International —Cape Canaveral, FL
- Full-time
- Hybrid work
- Office
- High school diploma or GED
- Analysis skills
Quick Apply
20h
Physician Liaison
BlueSprig —Jacksonville, FL
- From $65,000 a year
- Full-time
- Marketing
- Physical & Rehabilitation Medicine
- Mid-level
Quick Apply
5d
Physician Liaison (Marketing)
Heart and Vascular Care, PA —Orlando, FL
- $20 - $23 an hour
- Full-time
- Bilingual
- Background check
- Private practice
- Disability insurance
- Health insurance
Quick Apply
Provider Relations Specialist
Integrated Home Care Services —Miramar, FL
- Customer service
- Writing skills
- Mid-level
- Paid training
- Wellness program
Quick Apply
Provider Relations Specialist
Integrity Marketing Group —Clearwater, FL
- Full-time
- Word processing
- Research
- Windows
- Paid holidays
- Health insurance
Quick Apply
Physician Relations Specialist - Wesley Chapel Sales Representative
AdventHealth Tampa —Wesley Chapel, FL
- $60,151.66 - $111,886.39 a year
- Full-time
- Background check
- Marketing
- Hospital
- Paid parental leave
- Disability insurance
Physician Liaison - East
Shriners Hospitals for Children —Tampa, FL
- $73,569.60 - $110,344.00 a year
- Full-time
- Remote
- 18 years or older
- Marketing
- Mid-level
Quick Apply
Physician Liaison - Central Region
Shriners Hospitals for Children —Tampa, FL
- $73,569.60 - $110,344.00 a year
- Full-time
- Remote
- 18 years or older
- Marketing
- Mid-level
Quick Apply
Physician & Community Relations Manager
South Florida Orthopaedics & Sports Medicine PA —Lake Worth, FL
- Full-time
- Marketing
- 5 years
- Bachelor's degree
- Health insurance
- Dental insurance
Provider Relations & Marketing Coordinator
1st Choice Compounding Pharmacy —Holiday, FL
- $20 - $26 an hour
- Full-time
- Mid-level
- Organizational skills
- Contracts
- Health insurance
- Dental insurance
Quick Apply
12d

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provider relations jobs near florida

Health Plan Provider Relations Manager (North Central Florida)

Molina Healthcare -
Jacksonville, FL

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Job Details

Full-time
$60,415 - $117,809 a year
7 days ago

Benefits

Health insurance

Qualifications

Managed care organization experience
Presentations for conferences or internal meetings
Schedule management
Health insurance knowledge
Medicare regulations
Relationship management
Productivity software
Healthcare reimbursement methods
Cross-functional collaboration
Cross-functional communication

Full Job Description

JOB DESCRIPTION Job Summary

Provides subject matter expertise and leadership 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.

Candidates may reside in any county within Region B, including Lafayette, Suwannee, Hamilton, Dixie, Gilchrist, or Columbia County.

Essential Job Duties

Successfully engages the plan's highest priority, high-volume and strategic complex provider community providers (including value-based payment (VBP) and other alternative payment method (APM) contracts 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 for 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.
Resolves complex provider issues that may cross departmental lines including contracting, finance, quality, operations, and may involve senior leadership.
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.).
Oversees and demonstrates accountability for provider satisfaction survey results.
Develops and deploys strategic network planning tools to drive provider relations and contracting strategy across the enterprise.
Facilitates strategic planning and documentation of network management standards and processes (effectiveness is tied to financial and quality indicators).
Works collaboratively with functional business unit stakeholders to lead and/or support various provider services functions with an emphasis on developing and implementing standards and best practice sharing across the organization.
Navigates the matrix team environment including: new markets provider/contract support services, resolution support, and national contract management support services.
Serves as a subject matter expert for the provider relations function.
Provides training, mentoring, and support to new and existing provider relations team members.
Role requires 80%+ 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 6 years of provider services experience, including experience supporting individual/group providers, hospitals, integrated delivery systems, and ancillary providers with Medicaid, Medicare, and or Marketplace products, or equivalent combination of relevant education and experience.
Strong understanding of the health care delivery system, including government-sponsored health plans.
Experience 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.
Previous experience with community agencies and providers.
Strong organizational skills and attention to detail.
Ability to manage multiple tasks and deadlines effectively.
Experience with preparing and presenting formal presentations.
Strong interpersonal skills, including ability to interface with providers and medical office staff.
Ability to work in a cross-functional highly matrixed organization.
Strong verbal and written communication skills.
Microsoft Office suite and applicable software programs proficiency.

Preferred Qualifications

Management/leadership experience.
Contract negotiation experience.

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: $60,415 - $117,809 / ANNUAL
*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 florida

Health Plan Provider Relations Manager (North Central Florida)

Senior Project Manager, Provider Engagement Enablement

Senior Provider Relations Advocate - Miami, FL - Bilingual Spanish Required

Provider Contracting Professional (Dental Network)

Rep, Hospital Provider Relations HP

Health Plan Provider Relations Manager (North Central Florida)

Provider Relations Specialist

Network Relations Manager – Florida

Sr. Provider Relations Representative

Director, Provider Relations

Provider Network Relations Quality Specialist

Physician Liaison

Physician Liaison (Marketing)

Provider Relations Specialist

Provider Relations Specialist

Physician Relations Specialist - Wesley Chapel Sales Representative

Physician Liaison - East

Physician Liaison - Central Region

Physician & Community Relations Manager

Provider Relations & Marketing Coordinator

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