Top 416 Customer relations representative Jobs in Wayne, Nj

Representative, Health Plan Provider Relations - Remote Must reside in NY
Molina Healthcare —New York, NY
- $19.84 - $46.42 an hour
- Full-time
- Remote
- Medical office experience
- Mid-level
- Travel
- Health insurance
Telephone Representative II (Provider Relations)
1199SEIU Family of Funds —New York, NY
- $49,495.68 - $62,570.04 a year
- Full-time
- Research
- Mid-level
- High school diploma or GED
- Vision insurance
Customer Relations Representative - State Farm Agent Team Member
Hugo Gonzalez - State Farm Agent —Hoboken, NJ
- $21 - $24 an hour
- Full-time
- Office
- Leadership
- Entry level
- Health insurance
- Dental insurance
Quick Apply
Specialist I, Quality Assurance
SGS —Fairfield, NJ
- $23 - $27 an hour
- Full-time
- Bachelor of Science
- Bachelor's degree
- Entry level
- Health insurance
- Dental insurance
Quick Apply
Account Representative - State Farm Agent Team Member
Jason Bush - State Farm Agent —Wayne, NJ
- $50,000 - $75,000 a year
- Full-time
- Office
- Communication skills
- Marketing
- Paid time off
- Opportunities for advancement
Quick Apply
People Resource (HR) Generalist
The RealReal —Secaucus, NJ
- $75,000 - $85,000 a year
- Full-time
- Spanish
- Google Workspace
- Mid-level
- Paid parental leave
- Employee stock purchase plan
Quick Apply
Customer Resolution Specialist
AJ Madison —Brooklyn, NY
- $25 - $30 an hour
- Full-time
- Hybrid work
- Research
- Mid-level
- Continuous improvement
Quick Apply
Security Services-Contract Site Manager
Gateway Group One —Newark, NJ
- $40.86 - $43.26 an hour
- Full-time
- Customer service
- Conflict management
- Mentoring
Quick Apply
Outside Sales Representative – Food Distribution
Maximum Quality Foods Inc —New Jersey
- $70,000 - $90,000 a year
- Overtime
- Basic math
- Mid-level
- Ability to lift 50 pounds
- Health insurance
- Dental insurance
Quick Apply
MAP Sales Representative II
MetroPlusHealth: Direct —New York, NY
- $65,592 a year
- Weekends as needed
- Addiction Medicine
- Mid-level
- Office
- Disability insurance
- Health insurance
1d
Sales Representative
Confidential —Newark, NJ
- $70,000 - $80,000 a year
- Full-time
- Microsoft Outlook
- Customer service
- Computer literacy
- Health insurance
- Dental insurance
Quick Apply
22h
Medicare Sales Representative II
MetroPlusHealth: Direct —New York, NY
- $65,592 a year
- Bilingual
- Microsoft Word
- Microsoft Excel
- Disability insurance
- Health insurance
1d
Transition Specialist Representative - New Jersey
PAYCOM —Jersey City, NJ
- $100,000 a year
- Full-time
- Microsoft Outlook
- Public speaking
- Research
Quick Apply
MAP Sales Representative II - NYS Life, Accident and Health License Required
MetroPlusHealth —New York, NY
- $65,592 a year
- Weekends as needed
- Addiction Medicine
- Mid-level
- 3 years
Quick Apply
1d
Leasing Consultant
Confidential —Haverstraw, NY
- $22 - $26 an hour
- Weekends as needed
- Background check
- Microsoft Outlook
- Marketing
- Health insurance
- Dental insurance
Quick Apply
Medicare Sales Representative II - Staten Island (NYS Life, Accident, and Health)
MetroPlusHealth —New York, NY
- $65,592 a year
- Bilingual
- Microsoft Excel
- Hospital
Quick Apply
1d
Permit Technician
Tuff Shed —Fairfield, NJ
- $21.95 - $25.45 an hour
- Full-time
- Oracle
- Writing skills
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
Medicare Sales Representative II - Queens & Brooklyn (NYS Life, Accident, and Health)
MetroPlusHealth —New York, NY
- $65,592 a year
- Bilingual
- Microsoft Excel
- Hospital
Quick Apply
1d
Relationship Manager , Funds
ICICI Bank New York —Manhattan, NY
- Full-time
- Bachelor's degree
- US work authorization
- In-person
- Health insurance
Quick Apply
Supervising Journeyman Electrician
Lane Valente Industries —Mahwah, NJ
- Full-time
- Construction site
- Customer service
- High school diploma or GED
- Health insurance
- Dental insurance
Quick Apply

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Representative, Health Plan Provider Relations - Remote Must reside in NY

Molina Healthcare -
New York, NY

Apply Now

Job Details

Full-time
$19.84 - $46.42 an hour

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

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.

will require to travel at least once a week subject to change.

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: $19.84 - $46.42 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply Now

Refine Your Search

customer relations representative jobs in wayne, nj

Representative, Health Plan Provider Relations - Remote Must reside in NY

Telephone Representative II (Provider Relations)

Customer Relations Representative - State Farm Agent Team Member

Specialist I, Quality Assurance

Account Representative - State Farm Agent Team Member

People Resource (HR) Generalist

Customer Resolution Specialist

Security Services-Contract Site Manager

Outside Sales Representative – Food Distribution

MAP Sales Representative II

Sales Representative

Medicare Sales Representative II

Transition Specialist Representative - New Jersey

MAP Sales Representative II - NYS Life, Accident and Health License Required

Leasing Consultant

Medicare Sales Representative II - Staten Island (NYS Life, Accident, and Health)

Permit Technician

Medicare Sales Representative II - Queens & Brooklyn (NYS Life, Accident, and Health)

Relationship Manager , Funds

Supervising Journeyman Electrician

I want to receive the latest job alert for customer relations representative in wayne, nj

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