Provider Relations Representative

4 weeks ago

Dallas, United States Health Plans Inc Full time
Job DescriptionJob Description

Employers Health Network, LLC (EHN) creates community-based healthcare networks and a unique governance model to form a true partnership between self-funded employers and providers. With a commitment to improving healthcare outcomes while managing costs, we strive to create a healthier and more productive workforce/ Our networks bring together employers and healthcare providers to collaborate and deliver high-quality, high-value care.


ROLE AND RESPONSIBILITIES

The Provider Relations Representative possesses an integration of inter-personal, administrative, and specialized skill sets. This role assists in managing key provider relationships in all EHN Markets. The Provider Relations Representative will also assist in day-to-day network activity including but not limited to, provider roster management, provider education, provider onboarding, provider communications, communicating with clients, provider relations special projects and other duties as assigned. The main responsibilities include but are not limited to:

  • Assist in establishing and maintaining strong relationships with hospitals, physician groups, and ancillary providers that participate in the EHN network.
  • Support special projects, as assigned by Provider Relations Manager.
  • Review, track, and process new provider rosters in a timely manner.
  • Ensure health care groups are compliant with EHN provider manual and provide education around topics within the manual, plan guidelines, and clients.
  • Monitor, track and resolve inquiries received via provider relations email box, phone, or other communication.
  • Update and keep current tracking system for issue resolutions, special projects, rosters, etc.
  • Actively participate in provider meetings as needed or requested.
  • Work collaboratively with Network Operations team to resolve provider issues.
  • Proactively onboard and educate new and existing providers regarding network participation, EHN recognition, provider manual, clients that access the network, and other topics as needed.
  • Attend, complete, and demonstrate competency in all required HIPAA Training offered by the company.
  • Create and support provider communications such as welcome letters, Quick Reference Guides, Newsletters, etc.
  • Attend open enrollment sessions or in person provider meetings as requested.
  • Other duties and projects as needed and assigned by the Provider Relations Manager.

QUALIFICATIONS AND EDUCATION REQUIREMENTS

  • Bachelor’s Degree or equivalent Provider Relations experience
  • 3-5 years of provider relations experience
  • Demonstrate excellent presentation, verbal and written communication skills
  • Experience with client or provider relations, preferably in self-insured employer market
  • Proficiency with MS Excel, Word, and PowerPoint

TRAVEL REQUIREMENTS

  • Approximately 10% as needed

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