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Provider Relations Specialist
4 months ago
The Provider Relations & Operations Specialist is responsible for the full range of contracting, provider relations and operations/service interactions with providers that ensure our patients have superior access to the highest quality, cost-effective providers of healthcare services.
Education & Experience:
- Bachelor's Degree preferred or in process of completion or equivalent experience.
- Must have a minimum of five years of work experience in managed care in Medicare/Medicaid and Medicare Advantage populations with demonstrated strong relationship building skills.
- Must have a minimum of three years of work experience in working with health plans or provider group/clinic/facilities.
Knowledge, Skills and Abilities:
- Must have a high level of interpersonal skills to handle sensitive and confidential situations.? Demonstrated ability to de-escalate situations by problem-solving and providing excellent service to internal and external clients.
- Position continually requires demonstrated poise, tact, negotiation and diplomacy.
- Must have excellent verbal and written skills.
- Must be able to interact and communicate with individuals at all levels of the organization and external parties.
- Must have advanced knowledge of variety of computer software applications in word processing, spreadsheets, database and presentation software (Word, Excel, Access, PowerPoint)
- Must be able to work in a fast-paced environment with demonstrated ability to juggle multiple competing tasks and demands.
- Excellent organization and coordinating skills.? Work requires continual attention to detail in composing, typing and proofing contracts.
- Ability to travel locally and within the state. Travel will be required to engage with potential clients, develop relationships with physicians, clinical teams, etc. and overall build the organization.
- Responsible for building positive relationships between P3 Health Partners and the health plan, providers and practice managers.
- Acts as a liaison for various contracting projects for hospitals, ancillary, primary care physicians, and specialists.
- Training and development of external provider education programs.
- Identifying gaps in network composition and services to assist the market coverage of contracted services.
- Identifying and remediating operational short-falls and researching and remediating issues.
- Handles confidential and non-routine information.
- Delivers assigned projects on time and compliant to applicable state and federal regulations.? Organizes and prioritizes large volumes of information.
- General administrative duties.
