Top 1585 Business services representative Jobs in Nebraska

Senior Representative, Health Plan Provider Relations - Remote Must reside in NE
Molina Healthcare —Nebraska
- $47,433.00 - $97,362.61 a year
- Full-time
- Remote
- Medical office experience
- Contracts
- Senior level
- Health insurance
6d
SLED Account Manager
Nutanix —Omaha, NE
- $201,600 - $302,400 a year
- Full-time
- Remote
- Mid-level
- Bachelor's degree
- Experience equivalent to degree accepted
- Paid time off
- Parental leave
11d
Inside Sales Representative
Hayes Handpiece Franchises, Inc. —Nebraska
- $45,000 - $65,000 a year
- Remote
- High school diploma or GED
- Bachelor's degree
- Organizational skills
- On-the-job training
Quick Apply
Executive Director
Box Butte Development Corporation —Alliance, NE
- $65,000 - $72,000 a year
- Full-time
- Bachelor's degree
- Mentoring
- US work authorization
- Health insurance
- Paid time off
Quick Apply
7d
Senior Vice President, Distribution
Great West, an Old Republic Company —South Sioux City, NE
- Customer service
- Office
- Driver's License
Quick Apply
3d
Retail Field & or Network Technicians
Mobile Technologies Inc. —Omaha, NE
- $20 - $25 an hour
- Part-time
- 18 years or older
- Mid-level
- Driver's License
Quick Apply
Retail Field & or Network Technicians
Mobile Technologies Inc. —Ralston, NE
- $20 - $25 an hour
- Part-time
- 18 years or older
- Mid-level
- Driver's License
Quick Apply
Agronomy Sales
Confidential —Dawson County, NE
- $45,000 - $250,000 a year
- Full-time
- Marketing
- Mid-level
- Business development
- Travel reimbursement
- Paid time off
Quick Apply
1d
Wireless Sales Associate
Team Wireless - Verizon Authorized Retailer —Ord, NE
- From $70,000 a year
- Weekends as needed
- Computer literacy
- Communication skills
- Entry level
- Paid parental leave
- Paid holidays
Quick Apply
Pharmacy Customer Service Representative I
ONEWORLD COMMUNITY HEALTH CENTERS INC —Omaha, NE
- Full-time
- 18 years or older
- Spanish
- Microsoft Excel
- Health insurance
- Dental insurance
Eastern Nebraska Territory Trailer & Truck Body Sales Representative
M.H. EBY, Inc. —Omaha, NE
- $100,000 - $120,000 a year
- Full-time
- Dealership
- Mid-level
- Driver's License
- Health insurance
- Dental insurance
Quick Apply
Outside Sales Representative
Patton Equipment Company, Inc. —Omaha, NE
- From $4,000 a month
- Full-time
- Background check
- Mid-level
- High school diploma or GED
- Health insurance
- Life insurance
Quick Apply
Ground Freight Sales Representative
Crane Cartage LLC —Omaha, NE
- Mid-level
- Computer skills
- Communication skills
- Wellness program
- Health insurance
Fuels Technician
BBCH —Nebraska
- $30 - $40 an hour
- Full-time
- Background check
- CPR Certification
- Construction site
- Health savings account
- Disability insurance
Quick Apply
Route Sales Representative
Hawkins Inc —Roca, NE
- $60,000 - $70,000 a year
- Call employer
- Computer literacy
- Basic math
- DOT physical examination
- Paid training
- Employee stock purchase plan
Quick Apply
Outside Sales Representative
UniFirst —Omaha, NE
- Full-time
- Clean driving record
- Driver's License
- Driving
- Fuel card
- Paid holidays
Business Development Representative - Truck Brokerage
Able Transport Solutions —Omaha, NE
- $50,000 - $70,000 a year
- Full-time
- Mid-level
- Office
- Business development
- Paid training
- Paid holidays
Quick Apply
Diesel Technician - Mechanic - Waterloo, NE
Lyman-Richey Sand & Gravel Company —Waterloo, NE
- 18 years or older
- Pass drug screening
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
7d
Field Service Specialist - Columbus, NE
Gerhold Concrete Company, Inc. —Columbus, NE
- Weekends as needed
- Background check
- 18 years or older
- Microsoft Excel
- Health insurance
- Dental insurance
Quick Apply
6d
Warehouse Office Clerk
Southshore Enterprises, Inc. —York, NE
- From $19 an hour
- Overtime
- Bilingual
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply

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Senior Representative, Health Plan Provider Relations - Remote Must reside in NE

Molina Healthcare -
Nebraska

Apply Now

Job Details

Full-time
$47,433.00 - $97,362.61 a year
6 days ago

Benefits

Health insurance

Qualifications

Customer training
Medicare
Managed care organization experience
Medical office experience
Educational talks
Schedule management
Corporate training teaching experience
Health insurance knowledge
Medicare regulations
Medicaid regulations
Medicaid
Productivity software
Healthcare reimbursement methods
Cross-functional collaboration
Cross-functional communication

Full Job Description

JOB DESCRIPTION Job SummaryProvides senior level 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 the plan's highest priority, high-volume and strategic complex community 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 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 and 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.).
Serves as a subject matter expert for the provider relations function.
Provides training 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 3 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.
Understanding of the health care delivery system, including government-sponsored health plans.
Understanding of 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.
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

Experience in provider services, operations, and/or contract negotiations in a Medicaid, Medicare, and/or Marketplace managed health care setting - ideally with different provider types (i.e. physician, group, hospital).

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: $47,433 - $97,362.61 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply Now

Refine Your Search

business services representative jobs in nebraska

Senior Representative, Health Plan Provider Relations - Remote Must reside in NE

SLED Account Manager

Inside Sales Representative

Executive Director

Senior Vice President, Distribution

Retail Field & or Network Technicians

Retail Field & or Network Technicians

Agronomy Sales

Wireless Sales Associate

Pharmacy Customer Service Representative I

Eastern Nebraska Territory Trailer & Truck Body Sales Representative

Outside Sales Representative

Ground Freight Sales Representative

Fuels Technician

Route Sales Representative

Outside Sales Representative

Business Development Representative - Truck Brokerage

Diesel Technician - Mechanic - Waterloo, NE

Field Service Specialist - Columbus, NE

Warehouse Office Clerk

I want to receive the latest job alert for business services representative in nebraska

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