Provider Relations Specialist

3 weeks ago

Stockton, United States P3 Health Partners Full time
Overall Purpose

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.
Essential Functions
  • 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.

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