Top 53 Business development center representative Jobs in Lexington Sc

Health Plan Provider Relations Representative
Molina Healthcare —Lexington, SC
- $18.85 - $38.69 an hour
- Full-time
- Medical office experience
- Mid-level
- Training & development
- Health insurance
7d
Inside Sales Representative- Remote
Rhythmlink International LLC —Columbia, SC
- $70,000 - $100,000 a year
- Full-time
- Remote
- Google Workspace
- Anatomy knowledge
- Mid-level
- Health insurance
12d
Senior Sales Representative - Pelvic Health- Columbia, SC
Medtronic —Columbia, SC
- $75,000 a year
- Full-time
- Remote
- Hospital
- Customer service
- High school diploma or GED
- Health savings account
- Employee stock purchase plan
Area Sales Coordinator
HILTON COLUMBIA CENTER —Columbia, SC
- Inventory management
- Mid-level
- Hotel
- Health insurance
- Dental insurance
Quick Apply
12d
Medical Officer
American Red Cross —South Carolina
- $200,000 - $250,000 a year
- Full-time
- Medicine
- Doctoral degree
- Up to 50% travel
- Health savings account
- Paid holidays
Quick Apply
10d
Business Development Center (BDC) Representative
Classic Ford Lincoln - Columbia —Columbia, SC
- Full-time
- Business development
- Entry level
- Time management
- Paid training
- Disability insurance
Quick Apply
BDC REPRESENTATIVE
Stivers Automotive Group —Columbia, SC
- $15 - $17 an hour
- Weekends as needed
- Computer literacy
- Administrative experience
- Computer skills
- Health insurance
- Dental insurance
Quick Apply
7d
Retail Regional Manager- Columbia, SC and surrounding areas
Fifth Third Bank —Columbia, SC
- Full-time
- Mid-level
- Office
- Mentoring
4d
Sales Development Training Program
TK Elevator Corporation —Columbia, SC
- $31.25 an hour
- Full-time
- Residential
- Bachelor's degree
- Contracts
Area Sales Director, SE Surgical Sales
Owens & Minor Distribution Inc. —Columbia, SC
- $140,000 - $170,000 a year
- Full-time
- Acute care
- Clean driving record
- 5 years
- Health savings account
- Disability insurance
Quick Apply
Assistant Professor
University of South Carolina —Richland, SC
- $185,000 - $190,000 a year
- Full-time
- University
- Doctor of Philosophy
- Military encouraged
- Health insurance
- Life insurance
Medical Sales Representative
American Health Imaging —Columbia, SC
- Full-time
- Mid-level
- Analysis skills
- Bachelor's degree
Quick Apply
Project Estimator
CONTOUR MINING AND CONSTRUCTION —Columbia, SC
- 8 hour shift
- Microsoft Word
- Microsoft Excel
- Schematics
Quick Apply
Mornings & Afternoons
Sierra —Columbia, SC
- $12.75 - $13.25 an hour
- Part-time
- Merchandising
- Organizational skills
- Fair chance
- Paid parental leave
- Health savings account
4d
Retail Sales Associate
Marshalls —Columbia, SC
- $12.75 - $13.25 an hour
- Part-time
- Merchandising
- Organizational skills
- Fair chance
- Paid parental leave
- Health savings account
6d
Open Rank Tenure-Track Faculty
University of South Carolina —Richland, SC
- $185,000 - $215,000 a year
- Full-time
- University
- Doctor of Philosophy
- Military encouraged
- Health insurance
- Life insurance
Store Manager
Boot Barn —Columbia, SC
- Extended hours
- Heavy lifting
- Merchandising
- Mid-level
- Store discount
- Health insurance
Quick Apply
4d
Customer Engineer - Columbia, SC
Vertiv —Columbia, SC
- Weekends as needed
- Background check
- Military
- Pass drug screening
- Profit sharing
- Health insurance
CEI Inspector I
Bowman Consulting Group, Ltd. —Columbia, SC
- Full-time
- Construction site
- Writing skills
- No experience needed
- Paid holidays
- Disability insurance
2d
Design Professional - K12 - West Columbia
McMillan Pazdan Smith LLC —West Columbia, SC
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Research
Quick Apply

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business development center representative jobs near lexington sc

Health Plan Provider Relations Representative

Molina Healthcare -
Lexington, SC

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Job Details

Full-time
$18.85 - $38.69 an hour
7 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.

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Refine Your Search

business development center representative jobs in lexington sc

Health Plan Provider Relations Representative

Inside Sales Representative- Remote

Senior Sales Representative - Pelvic Health- Columbia, SC

Area Sales Coordinator

Medical Officer

Business Development Center (BDC) Representative

BDC REPRESENTATIVE

Retail Regional Manager- Columbia, SC and surrounding areas

Sales Development Training Program

Area Sales Director, SE Surgical Sales

Assistant Professor

Medical Sales Representative

Project Estimator

Mornings & Afternoons

Retail Sales Associate

Open Rank Tenure-Track Faculty

Store Manager

Customer Engineer - Columbia, SC

CEI Inspector I

Design Professional - K12 - West Columbia

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