Top 1080 Remote work from home Jobs in Healdsburg, Ca

Provider Relations Representative
Imperial Management Administrators Services Inc —Santa Rosa, CA
- $70,000 - $74,000 a year
- Remote
- Microsoft Excel
- Microsoft Outlook
- Marketing
Quick Apply
Customer Service Representative - EMS Experience - Remote
ProTransport-1, LLC —Cotati, CA
- From $16.90 an hour
- 12 hour shift
- Remote
- Writing skills
- High school diploma or GED
- Typing
Quick Apply
12d
Licensed Clinical Social Worker
Headway —California
- Up to $117.73 an hour
- Remote
- Private practice
- Licensed Clinical Social Worker
- Mid-level
Quick Apply
Licensed Professional Counselor
Headway —California
- Up to $117.73 an hour
- Remote
- Private practice
- Master's degree
- Senior level
California Based Federal & State Grant Writer – Municipal Clients (1–3 Years Experience)
Blais & Associates —California
- From $25 an hour
- Part-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Research
- 401(k)
- 401(k) matching
Quick Apply
California Licensed Child Psychologist | Build Your Insurance-Based Practice with Lean Medical
Lean Medical Inc —California
- $100,000 - $350,000 a year
- Choose your own hours
- Remote
- Adults
- Mid-level
- Outpatient experience
Quick Apply
Independently Licensed Mental Health Therapist (PTSD) - California
Rebound —California
- $55,000 - $110,000 a year
- Weekends as needed
- Remote
- LMFT
- Licensed Clinical Social Worker
- Mid-level
- Paid parental leave
- Health insurance
Quick Apply
Russian-English Bilingual Healthcare Customer Service Representative - Remote in California
TTEC —California
- $21.65 an hour
- Full-time
- Remote
- English
- Research
- Windows
- Wellness program
- Tuition reimbursement
Vietnamese-English Bilingual Healthcare Customer Service Representative - Remote in California
TTEC —California
- $21.65 an hour
- Full-time
- Remote
- English
- Research
- Windows
- Wellness program
- Tuition reimbursement
Licensed Clinical Psychologist
Headway —California
- Up to $134 an hour
- Remote
- Private practice
- Master's degree
- Psychology
Insurance Defense Attorney (2-5+ Years) - 3641855
Resnick & Louis, P.C. —California
- Full-time
- Remote
- Background check
- Customer service
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Labor & Employment Attorney
Wood, Smith, Henning & Berman —California
- $120,000 - $190,000 a year
- Full-time
- Remote
- Writing skills
- Mid-level
- 1 year
- Disability insurance
- Health insurance
Quick Apply
Insurance Defense Attorney (Partner Level) - 2984199
Resnick & Louis, P.C. —California
- Full-time
- Remote
- US work authorization
- Senior level
- 10 years
- Health insurance
- Dental insurance
Quick Apply
10d
Part-time Child & Adolescent Mental Health Therapist (California)
Handspring Health —California
- $90 - $110 an hour
- Part-time
- Remote
- Background check
- LMFT
- Licensed Clinical Social Worker
- Continuing education credits
- Paid time off
Licensed Professional Clinical Counselor
Grow Therapy —California
- $70 - $98 an hour
- Part-time
- Remote
- Mid-level
- Psychology
- In-person
- Continuing education credits
- Professional development assistance
6d
Remote Psychiatric Nurse Practitioner (PMHNP) with 103/104 NP Cert - Telehealth, W2, Benefits & more
Talkiatry —California
- $180,000 - $215,000 a year
- Part-time
- Remote
- Nursing
- Psychiatry
- Mid-level
- Health savings account
- Paid holidays
Licensed Marriage and Family Therapist
Headway —California
- Up to $117.73 an hour
- Remote
- Private practice
- LMFT
- Mid-level
Licensed Therapist or Psychologist (LPCC, LCSW, or LMFT)
Grow Therapy —California
- $70 - $98 an hour
- Part-time
- Remote
- LMFT
- Licensed Clinical Social Worker
- Mid-level
- Continuing education credits
- Professional development assistance
6d
Cambodian-English Bilingual Healthcare Customer Service Representative - Remote in California
TTEC —California
- $22.65 an hour
- Full-time
- Remote
- English
- Research
- Windows
- Wellness program
- Tuition reimbursement
Licensed Clinical Social Worker
Grow Therapy —California
- $70 - $98 an hour
- Part-time
- Remote
- Licensed Clinical Social Worker
- Mid-level
- In-person
- Continuing education credits
- Professional development assistance
6d

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Provider Relations Representative

Imperial Management Administrators Services Inc -
Santa Rosa, CA

Quick Apply

Job Details

$70,000 - $74,000 a year

Qualifications

Customer communication
Microsoft Excel
Microsoft Outlook
English
Driver's License
Negotiating purchasing contracts

Full Job Description

Must reside in the North Bay, California area (Marin, Napa, Solano or Sonoma County)

JOB DESCRIPTION

JOB TITLE: Provider Network Administrator FLSA STATUS: Exempt

DEPARTMENT: Provider Network Management

REPORTS TO: Sr. Provider Network Administrator

JOB SUMMARY: Maintains a successful working relationship between Imperial Health Plans, network providers, and partner health plans through a full range of provider relations and service interactions to ensure network adequacy, and provider relations. Identify and communicate operational issues raised by providers, respond to customer complaints, customer satisfaction surveys and provider questions, and research and resolve accounts payable issues. Routinely negotiate cost effective fees for single services, confirm service capability and educate providers on contract expectations, processes, and paperwork. Comprehend detailed knowledge of Imperial’s requirements in order to adapt agreements, contractual requirements and fee agreements to the specific situation. Must be able to routinely evaluate and analyze the most beneficial solution for Imperial and our network providers in a variety of circumstances.

ESSENTIAL JOB FUNCTIONS:

1. Complete required Provider Office Face-to Face Visitation (daily, weekly, monthly) as assigned or predetermined by department management.

2. Assess and resolve specific provider concerns, developing and implementing solutions that are beneficial to providers, Imperial Members and Imperial.

3. Maintain network adequacy. Lead efforts to obtain letter of agreements as necessary.

4. Onboard new providers within 10 business days. Train providers on an annual basis.

5. Assess and respond to leads generated by brokers, providers, and customers.

6. Negotiate fees that align provider needs and Imperial business objectives. Educate providers on fee structures to ensure collaborative agreement and understanding of Imperial Services and the fees associated with them.

7. Staff Provider Relations Telephone Queue, adequately respond to and resolve incoming calls in the appropriate manner.

8. Respond to Customer Satisfaction Surveys and Customer Complaints within the required time frame through investigation and problem solving that results in positive outcomes.

9. Provide explanations and information to others on topics within area of expertise.

10. Proactively review and maintain provider compliance documents to ensure active status within provider network.

11. Collaborate with other departments to assign qualified providers to orders within the contractually allowed mileage radius of the patient's home zip code.

12. Maintains regular and consistent attendance.

13. Adheres to Compliance Plan and HIPAA regulations.

MARGINAL JOB FUNCTIONS:

1. Takes on special projects as needed.

2. Performs other duties as assigned.

BEHAVIORAL EXPECTATIONS:

1. Continuous Learning:

a. Attends staff meetings as required.

b. Attends appropriate training, seminars and workshops as required

2. Customer Focus:

a. Maintains client/customer confidentiality and privacy in accordance with HIPPA regulations and IMAS’s Standards of Conduct.

b. Fosters appropriate communication and relations with Supervisor, co-workers and other staff.

3. Quality/Process Improvement/Safety

a. Reports issues of security, health and/or safety to appropriate supervisor as soon as practicable.

b. Supports and demonstrates safety throughout all duties performed.

c. Follows established policies and procedures and understands and complies with all regulators standards set forth by governing entities.

POSITION REQUIREMENTS:

EDUCATION/EXPERIENCE:

 High school graduate or equivalent.

 Bachelor’s Degree (or higher) in Business, Marketing, Communications or healthcare related field

 3+ years of related experience in provider relations, network management, customer service, contract negotiations, account services and/or account management, etc. (or High School Diploma /

GED and 3+ years of related experience)

SKILLS/KNOWLEDGE/ABILITY:

 Must reside in the County where work is assigned

 Microsoft Office Suite (Word, Outlook, Excel

 Knowledge of negotiating rates and managing subcontractor relationships

 Knowledge of Medicare and Medical terminology (preferred)

 Willingness and ability to read, write, speak, understand English and have the communications skills necessary to provide accurate information to residents and staff.

 Willingness and ability to follow written and verbal direction in English.

 Willingness and ability to maintain appropriate level of confidentiality and privacy.

 Willingness and ability to interact professionally with all customers, members, and co-workers, individually and as part of a team.

 Willingness and ability to effectively handle multiple items/tasks as required and adapt favorably to changing priorities.

 Willingness and ability to make appropriate judgments, decisions and problem solving in a timely manner and within the context of the situation at hand.

 Ability to effectively prioritize items/tasks as required.

 Willingness and ability to take initiative and be a self-starter.

 Willingness and ability to understand and comply with Federal, State, and local regulations.

LICENSURE/CERTIFICATE/TRAINING:

 Driver’s License – must have reliable transportation with automobile insurance

Quick Apply

Refine Your Search

remote work from home jobs in healdsburg, ca

Provider Relations Representative

Customer Service Representative - EMS Experience - Remote

Licensed Clinical Social Worker

Licensed Professional Counselor

California Based Federal & State Grant Writer – Municipal Clients (1–3 Years Experience)

California Licensed Child Psychologist | Build Your Insurance-Based Practice with Lean Medical

Independently Licensed Mental Health Therapist (PTSD) - California

Russian-English Bilingual Healthcare Customer Service Representative - Remote in California

Vietnamese-English Bilingual Healthcare Customer Service Representative - Remote in California

Licensed Clinical Psychologist

Insurance Defense Attorney (2-5+ Years) - 3641855

Labor & Employment Attorney

Insurance Defense Attorney (Partner Level) - 2984199

Part-time Child & Adolescent Mental Health Therapist (California)

Licensed Professional Clinical Counselor

Remote Psychiatric Nurse Practitioner (PMHNP) with 103/104 NP Cert - Telehealth, W2, Benefits & more

Licensed Marriage and Family Therapist

Licensed Therapist or Psychologist (LPCC, LCSW, or LMFT)

Cambodian-English Bilingual Healthcare Customer Service Representative - Remote in California

Licensed Clinical Social Worker

I want to receive the latest job alert for remote work from home in healdsburg, ca

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