Top 16 Provider relations Jobs in Miami Fl

Rep, Hospital Provider Relations HP
Molina Healthcare —Miami, FL
- $19.84 - $38.69 an hour
- Full-time
- Medical office experience
- Mid-level
- Training & development
- Health insurance
Provider Relations Manager (Behavioral Health)
Eating Recovery Center —Miami, FL
- $85,000 - $110,000 a year
- Weekends as needed
- Marketing
- Driver's License
- Bachelor's degree
- Health insurance
- Dental insurance
Quick Apply
1d
Provider Relations Specialist
Integrated Home Care Services —Miramar, FL
- Customer service
- Writing skills
- Mid-level
- Paid training
- Wellness program
Quick Apply
Provider Relations Account Executive
Independent Living Systems —Miami, FL
- Full-time
- Mid-level
- 3 years
- Master's degree
13d
Sr. Provider Relations Representative
CLAREMEDICA HEALTH PARTNERS LLC —Miami Lakes, FL
- Spanish
- English
- Ability to climb stairs
Quick Apply
Provider Network Configuration Specialist
Solis Health Plans —Doral, FL
- $25 - $27 an hour
- Full-time
- Mid-level
- 3 years
- Databases
Quick Apply
Physician Liaison / Business Development Representative
BioHealth Infusion Center —Miami, FL
- $50,000 - $80,000 a year
- Full-time
- Hybrid work
- Hospital
- Primary Care
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
14d
Physician Liaison
Fyzical —Coral Gables, FL
- Part-time
- Marketing
- Mid-level
- Clinic
- Mileage reimbursement
Director, Provider Relations
Independent Living Systems —Miami, FL
- Full-time
- 5 years
- Master's degree
- Bachelor's degree
Quick Apply
Oncology Provider Relations Representative (Pharmacy Technicians)
Southeastern Health Management —Miami, FL
- $70,000 - $85,000 a year
- Full-time
- Spanish
- Marketing
- 5 years
- Paid holidays
- Paid time off
Quick Apply
Healthcare Liaison (Physician Relations / Medical Sales)
Sustainable Talent —Plantation, FL
- Part-time
- Mid-level
- Reliable transportation
- Communication skills
Quick Apply
Vice President, Provider Networks
Independent Living Systems —Miami, FL
- Full-time
- Office
- Master's degree
- Bachelor's degree
Quick Apply
Provider Relations Representative
AT TALITHA CUMI HOME CARE —Hialeah, FL
- $15 - $17 an hour
- Full-time
- Spanish
- Microsoft Excel
- Microsoft Outlook
- Paid training
- 401(k)
Quick Apply
Physician Liaison
FYZICAL Therapy and Balance Centers —Coral Gables, FL
- $14 - $16 an hour
- Part-time
- Hybrid work
- Marketing
- Mid-level
- Clinic
- Mileage reimbursement
Quick Apply

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Rep, Hospital Provider Relations HP

Molina Healthcare -
Miami, FL

Apply Now

Job Details

Full-time
$19.84 - $38.69 an hour

Benefits

Health insurance

Qualifications

Customer communication
Managed care
Managed care organization experience
Schedule management
Health insurance knowledge
Productivity software
Cross-functional collaboration
Cross-functional communication

Full Job Description

JOB DESCRIPTION

**This role will support hospital providers throughout Florida**

Job Summary

Provides support for health plan hospital 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 80%+ same-day or overnight travel (extent of same-day or overnight travel will depend on the specific health plan service area) in N. Florida region

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.

Hospital experience highly preferred

#PJHPO

#LI-AC1

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: $19.84 - $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 miami fl

Rep, Hospital Provider Relations HP

Provider Relations Manager (Behavioral Health)

Provider Relations Specialist

Provider Relations Account Executive

Sr. Provider Relations Representative

Provider Network Configuration Specialist

Physician Liaison / Business Development Representative

Physician Liaison

Director, Provider Relations

Oncology Provider Relations Representative (Pharmacy Technicians)

Healthcare Liaison (Physician Relations / Medical Sales)

Vice President, Provider Networks

Provider Relations Representative

Physician Liaison

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