Current jobs related to Provider Relations Representative - New York - Molina Healthcare
-
New York, United States VNS Health Full timePlays a key role in supporting our VNS Health Upstate Network. Assists with building relationships with providers, assisting with operational tasks (such as credentialing and claims), and coordinating the implementation of performance improvement str Relations, Representative, Relationship, Health, Healthcare, Business Services
-
Provider Relations Specialist
2 weeks ago
New York, New York, United States Gainwell Technologies LLC Full timeAbout This RoleWe are seeking a highly skilled and experienced professional to join our team as a Provider Relations Representative at Gainwell Technologies LLC. This is an exciting opportunity to work in a dynamic and fast-paced environment, where you will play a critical role in supporting our clients in the healthcare industry.Key ResponsibilitiesProvide...
-
Provider Relations Coordinator
3 weeks ago
New York, New York, United States EmblemHealth Full timeOverviewServe as a crucial intermediary and maintain effective communication between designated facilities, ancillary services, delegated entities, and EmblemHealth. Oversee daily operations concerning contractual agreements with minimal oversight, focusing on contract enhancement, the rollout of new initiatives, and support for provider-related inquiries,...
-
Provider Relations Specialist
6 days ago
New York, New York, United States Gainwell Technologies LLC Full timeAbout the RoleWe are seeking a highly skilled and experienced Provider Relations Representative to join our team at Gainwell Technologies LLC. As a key member of our team, you will play a critical role in supporting our clients in delivering better health and human services outcomes.Key ResponsibilitiesProvide exceptional customer service to Medicaid...
-
Senior Public Relations Account Executive
3 weeks ago
New York, New York, United States Trust Relations Full timePosition OverviewTrust Relations is seeking a talented Senior Public Relations Account Executive to enhance our vibrant team. This role is designed for a remote freelancer (1099 contractor) who possesses a proven track record in executing innovative publicity initiatives within the consumer lifestyle sector, which encompasses various domains such as fashion,...
-
Freelance PR Senior Account Executive
4 weeks ago
New York, United States Trust Relations Full timeJob DescriptionJob DescriptionCompany Description Trust Relations Overview Trust Relations is a fast-growing, virtual branding, and strategic communications agency. We bypass the traditional agency model to build trusted brands, craft authentic stories, and engage diverse audiences — for marquee brands and disruptive startups alike.At Trust Relations, we...
-
Provider Relations Supervisor
3 weeks ago
New York, New York, United States 1199SEIU Funds Full timeKey Responsibilities Design and implement educational initiatives for providers associated with 1199SEIU Funds. Supervise Provider Relations Representatives, both in-field and in-house, ensuring they meet site visit targets and expectations through regular evaluations. Address complex issues including recruitment inquiries, fee negotiation requests,...
-
Public Relations Account Manager
6 days ago
Brooklyn, New York, United States Trust Relations Full timeAccount Manager Job DescriptionTrust Relations is seeking a skilled Account Manager to join our team. As a remote freelancer, you will work on executing innovative publicity campaigns in the consumer lifestyle space, including consumer brands, fashion, luxury, travel, food, and home.Key Responsibilities:Develop and execute strategic media relations plans for...
-
Senior Public Relations Executive
7 days ago
Brooklyn, New York, United States Trust Relations Full time{"Job Title": "Senior Public Relations Executive", "Job Description": "Position OverviewTrust Relations is seeking a highly skilled Senior Public Relations Executive to join our team. As a remote freelancer, you will be responsible for executing innovative publicity campaigns in the consumer lifestyle space, including consumer brands, fashion, luxury,...
-
Guest Relations Representative
1 week ago
New York, New York, United States Publicis Groupe Full timeJob Title: Guest Relations RepresentativePublicis Groupe is seeking a highly skilled Guest Relations Representative to join our Facilities Management team. As a key member of our team, you will be responsible for ensuring a clean, well-stocked, and professional-looking office environment is presented to our agency customers and external clients/visitors.Key...
-
Guest Relations Representative
1 day ago
New York, New York, United States Publicis Groupe Full timeJob Title: Guest Relations RepresentativeWe are seeking a highly organized and detail-oriented Guest Relations Representative to join our Facilities Management team. As a key member of our team, you will be responsible for ensuring a clean, well-stocked, and professional-looking office environment is presented to our agency customers and external...
-
Corporate Relations Director
1 week ago
New York County, New York, United States Council on Foreign Relations Full timeJob SummaryWe are seeking a highly skilled and experienced Corporate Relations Director to join our team at the Council on Foreign Relations. The successful candidate will be responsible for managing our corporate membership program, building relationships with key stakeholders, and driving business growth.Key ResponsibilitiesManage a portfolio of corporate...
-
Patient Relations Representative
4 weeks ago
New York, United States AB Hires and Consulting LLC Full timeAn established Home Care organization is looking for a Patient Relations Representative for their Brooklyn location. The organization is a fully licensed and bonded home health care agency serving Brooklyn, Manhattan, Queens, The Bronx, and Staten Island, as well as a Fiscal Intermediary in most New York counties, and is the home care agency of choice for...
-
Patient Relations Representative
4 weeks ago
New York, United States AB Hires and Consulting Full time $23 - $28Job DescriptionJob DescriptionAn established Home Care organization is looking for a Patient Relations Representative for their Brooklyn location. The organization is a fully licensed and bonded home health care agency serving Brooklyn, Manhattan, Queens, The Bronx, and Staten Island, as well as a Fiscal Intermediary in most New York counties, and is the...
-
Healthcare Provider Relations Specialist
3 weeks ago
Queens, New York, United States USA Clinics Group Full timeThe Healthcare Provider Relations Specialist serves as the key liaison for driving demand by implementing marketing strategies and advocating for USA Clinics Group. This role requires effective communication of comprehensive clinical knowledge regarding our services.Key Responsibilities• Advocate for USA Clinics Group services by engaging with healthcare...
-
Customer Relations Representative
3 weeks ago
New York, New York, United States Dynarex Full timeJob Title: Customer Service Agent Department: Customer Service Location: Orangeburg, NY Job Overview: Join our dedicated team and play a crucial role in enhancing customer experiences. As a Customer Service Agent, you will be the vital link between order placement and fulfillment, representing our brand and supporting customers throughout their journey. Key...
-
Provider Relations Specialist
3 weeks ago
New York, New York, United States New York City Health and Hospitals Corporation - Correctional Health Services Full timePosition Overview:As a vital member of our team, the Patient Portal Liaison will operate under the direction of the Provider Relations Manager. This role is essential in ensuring seamless communication and registration processes for our healthcare providers.Key Responsibilities:Assess and analyze registration information submitted by healthcare...
-
Provider Relations Specialist I
4 months ago
New York, United States CorVel Corporation Full timeAssists providers via phone and email with basic to complex bill review questions and requests. Documents bill review errors for tracking and trending to improve team error rate. Acts as a positive and professional representative of our CorVel family; ensures compliance with company best practice standards; ensure consistent, timely delivery of our quality...
-
Healthcare Provider Relations Specialist
7 days ago
New York, New York, United States Visiting Nurse Service of New York Full timeHealthcare Provider Relations SpecialistAt Visiting Nurse Service of New York, we are seeking a skilled Healthcare Provider Relations Specialist to join our team. In this role, you will be responsible for managing all aspects of provider relations within a specified geographic region.Key Responsibilities:Regularly visit and maintain ongoing contact with...
-
Healthcare Provider Relations Specialist
2 weeks ago
New York, New York, United States VNS Health Full timeAbout the RoleWe are seeking a skilled Healthcare Provider Relations Specialist to join our team at VNS Health. As a key member of our organization, you will play a vital role in supporting our VNS Health Upstate Network.Key ResponsibilitiesBuild and maintain relationships with healthcare providers to ensure their satisfaction and engagement with our...
Provider Relations Representative
4 months ago
***Remote and must live in downstate New York***
Job Description
Job Summary
Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for network management including provider education, communication, satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service.
Job Duties
This role serves as the primary point of contact between Molina Health plan and the for non-complex Provider Community that services Molina members, including but not limited to Fee-For-Service and Pay for Performance Providers. It is an external-facing, field-based position requiring a high degree of job knowledge, communication and organizational skills to successfully engage high volume, high visibility providers, including senior leaders and physicians, to ensure provider satisfaction, education on key Molina initiatives, and improved coordination and partnership.
• Under minimal direction, works 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. Effectiveness in driving timely issue resolution, EMR connectivity, Provider Portal Adoption.
• Conducts regular provider site visits within assigned region/service area. Determines own daily or weekly schedule, as needed to meet or exceed the Plan's monthly site visit goals. A key responsibility of the Representative during these visits is to proactively engage with the provider and staff to determine; for example, non-compliance with Molina policies/procedures or 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, which may include counseling providers diplomatically, while retaining a positive working relationship.
• Independently troubleshoots problems as they arise, making an assessment when escalation to a Senior Representative, Supervisor, or another Molina department is needed. 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. For example, such meetings would occur to discuss and resolve 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 JOC's).
• 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 - CAHPS, regulatory-related, Molina Quality programs, and taking advantage of electronic solutions (EDI, EFT, EMR, Provider Portal, Provider Website, etc.).
• Trains other Provider Relations Representatives as appropriate.
• Role requires 60%+ same-day or overnight travel. (Extent of same-day or overnight travel will depend on the specific Health Plan and its service area.)
Job Qualifications
REQUIRED EDUCATION:
Associate's Degree or equivalent provider contract, network development and management, or project management experience in a managed healthcare setting.
REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:
• 2 - 3 years customer service, provider service, or claims experience in a managed care setting.
• Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to, fee-for service, capitation and various forms of risk, ASO, etc.
PREFERRED EDUCATION:
Bachelor’s Degree in a related field or an equivalent combination of education and experience
PREFERRED EXPERIENCE:
• 3+ years experience in managed healthcare administration and/or Provider Services.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
#PJCorp
Pay Range: $17.85 - $38.69 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
