Provider Relations Representative

2 weeks ago


New York NY United States VNS Health Full time
Overview

Manages all aspects of provider relations within a specified geographic region. Regularly visits and maintains ongoing contact with existing/potential providers for relationship building, recruitment, credentialing, re-credentialing and assisting with provider issues and education. Works under general supervision.


Compensation:

$30.71 - $38.41 Hourly

What We Provide

  • Referral bonus opportunities
  • Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays
  • Health insurance plan for you and your loved ones, including Medical, Dental, Vision, Life and Disability
  • Employer-matched retirement saving funds
  • Personal and financial wellness programs
  • Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
  • Generous tuition reimbursement for qualifying degrees
  • Opportunities for professional growth and career advancement
  • Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities
  • Interdisciplinary network of colleagues through the VNS Health Social Services Community of Professionals

What You Will Do

  • Manages all provider contracts in designated territory, including recruitment, credentialing, recredentialing and relationship maintenance through regular visits and ongoing contact with existing and potential providers.
  • Prepares materials for and orients providers to contract terms and operating requirements, Health Plan program and eligibility requirements, and service coordination.
  • Collaborates with the Network Development and Contracting and Service Operations departments to administer demographic changes and renewals to provider contracts.
  • Monitors contract performance of network providers and serves as a liaison between the Health Plan and the Provider to ensure the flow of information regarding resolution of member service issues.
  • Coordinates provider site visits, as needed.
  • Coordinates and attends meetings to serve as a resource and address provider issues.
  • Updates and maintains provider manuals with current Health Plan policies and procedures.
  • Updates and proofs provider directories.
  • Assists providers in triaging billing and claims disputes.
  • Participates and collaborates with Compliance on Department of Health and internal audits.
  • Participates in special projects and performs other duties as assigned.

Qualifications

Licenses and Certifications:

  • Driver's license, required

Education:

  • Bachelor's Degree or equivalent related work experience, preferably in health care setting, required

Work Experience:

  • Minimum three years health care experience, required
  • Knowledge of government programs, including Medicare and Medicaid, preferred
  • Prior experience in Provider Relations, preferred
  • Reliable transportation to work sites, required
#J-18808-Ljbffr

  • San Diego, CA, United States Blue Shield of CA Full time

    The Network Management team is responsible for the development and maintenance of all provider networks, including vendor and Plan to Plan relationships necessary to provide our members and clients with access to quality, affordable health care services. The Provider Relations Consultant will report to the Provider Relations, Senior Manager. In this role,...


  • San Diego, CA, United States Blue Shield of CA Full time

    Your Role The value-based platform operations team provides the operational support for all the Blue Shield of California pay for value payment models. The Provider Relations Representative, Senior, will report to the Senior Manager of the value-based platform team. In this role, you will work with the providers to roll out and support the pay for value...


  • Los Angeles, CA, United States Blue Shield of CA Full time

    Your Role The Provider Relations Representative, Experienced is responsible for building and maintaining effective provider relationships with IPA/medical groups, PPO physicians, and hospitals, for all lines of business. The job entails delivering established quantifiable goals and targets for their assigned network of providers. Servicing the designated...


  • Des Moines, IA, United States Highwire Public Relations Full time

    About us: Highwire sets the standard for high-impact communications and marketing for global technology and healthcare companies, connecting reputation to revenue. As the top-ranked independent tech and healthcare PR firm, we represent some of the biggest brands in cloud, enterprise, security, fintech, healthcare, and consumer. We are nimble, creative and...


  • New York, NY, United States VantageScore Solutions LLC Full time

    About VantageScore At VantageScore we drive impact for good on a massive scale impacting tens of millions of people across the United States. Our mission is to be the leading credit modeling company delivering the most predictive, most innovative and most inclusive tri-bureau models and attributes in the US market. Our innovation is increasing access for...


  • Jersey City, NJ, United States Highwire Public Relations Full time

    About us: Highwire is a modern strategic communications and digital marketing agency designed for disruptive companies. We work with high-growth technology companies and established brands looking to reinvent themselves. At Highwire, we believe that storytelling fuels transformation. And the most impactful stories represent all voices and perspectives. As a...


  • Anaheim, CA, United States Providence Full time

    Description Under the supervision of the Senior Manager Provider Relations, this position is responsible for physician recruitment related activities and building relationships with Providence contracted physicians/specialist offices. Key responsibilities include Physician office in-services, continuous physician office education, fielding...


  • New York, New York, United States Metropolitan Jewish Health System Full time

    About Our CompanyMJHS companies are qualified employers under the Federal Government's Paid Student Loan Forgiveness Program (PSLF).Job DescriptionThis role is responsible for handling all provider file update requests, received from participating providers, in accordance with the established timeline while developing and maintaining positive...


  • Torrance, CA, United States Providencecu Full time

    Description Under the supervision of the Senior Manager Provider Relations, this position is responsible for physician recruitment related activities and building relationships with Providence contracted physicians/specialist offices. Key responsibilities include Physician office in-services, continuous physician office education, fielding questions,...


  • Torrance, CA, United States Providence Full time

    Description Under the supervision of the Senior Manager Provider Relations, this position is responsible for physician recruitment related activities and building relationships with Providence contracted physicians/specialist offices. Key responsibilities include Physician office in-services, continuous physician office education, fielding...


  • Washington, DC, United States Era Living, LLC Full time

    $28.85 - $31.25 per hour | Meaningful Work Helping Seniors | Great Benefits! | Free meals! | Free onsite parking! Era Living is seeking a full-time Community Relations Representative to become the newest member of our Community Relations team at Gardens at Town Square Community, a beautiful  retirement community in Bellevue, WA. The Community Relations...


  • New York, New York, United States MJHS Full time

    About the RoleThis is an exciting opportunity to join our Elderplan team as an Enrollment Coordinator! In this role, you will be responsible for handling all provider file update requests, developing and maintaining positive provider/customer services, and coordinating with various departments and teams to ensure that requests are handled appropriately and...


  • New York City, NY, United States MetroPlusHealth Full time

    Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day. About NYC Health + Hospitals MetroPlusHealth provides the highest...


  • San Francisco, CA, United States University of California - San Francisco Campus and Health Full time

    Labor and Employee Relations Representative Department: Human Resources Job Type: Full Time Job Code: 81866BR Job Summary The Labor and Employee Relations Representative leads local negotiations; conducts supervisory training; ensures that management interests are represented and employee rights are protected, and promotes proactive management practices...


  • York, United States SMG Inc Full time

    We are currently accepting applications from individuals with experience working in customer service, customer relations, and customer support to work as part of our team. Entry Level Customer Relations Representative’s will receive training to ensure they have all the skills and knowledge that they require to be successful in this high-energy industry. We...


  • Miami, FL, United States VXI Global Solutions Full time

    VXI is looking for highly motivated and qualified Customer Relations Representatives to work full-timefrom their home in the state of Texasfor our world-class contact center.The primary responsibility of this role requires you to interface with our clients vehicle owners, dealerships, and field/area offices regarding inquiries and/or complaints to positively...


  • New York, NY, United States Greenstaff Physician & Provider Solutions Full time

    Our client under the Evoke multibrand is in need of remote Neurophysiologist! Job Details: * Setting: Remote * Start date: As soon credentialing is complete * Patient demographic: Pediatrics to Geriatrics * Preference will be given to providers who are passionate about patient care. Provider can expect to work with academic centers and universities. The...


  • New York, New York, United States Maimonides Medical Center Full time

    About Maimonides HealthMaimonides Health, Brooklyn's leading healthcare system, serves over 250,000 patients annually through three hospitals, 1,800 physicians, and numerous community-based practices. Our core values H.E.A.R.T drive everything we do: Honesty, Empathy, Accountability, Respect, and Teamwork.We are a major clinical training site for SUNY...


  • New York, New York, United States Physician Affiliate Group of New York, P.C. (PAGNY) Full time

    We are seeking a skilled General Counsel for Labor Relations to join our team at PAGNY. This key role will involve managing legal affairs related to labor and employment issues, providing advice and counsel regarding applicable collective bargaining agreements, and representing the organization in state and federal court, before administrative tribunals and...


  • Rosemead, CA, United States Provider Healthcare Full time

    Garvey School District; Rosemead, California Job Type Full Time Schedule Monday - Friday Pay - Depends on Experience Patients Per Day 10-12 EMR System - Elation Work Location School; pediatrics up to age 18 Job ID 51027 Job Description A Rosemead, California based client is seeking an exceptional Nurse Practitioner or Physician Assistant to provide pediatric...