Provider Relations Specialist
23 hours ago
**Job Summary**
We are seeking a highly skilled Provider Relations Specialist to join our team at Blue Shield of California. As a key member of our Network Management team, you will play a critical role in developing and maintaining strong relationships with healthcare providers, ensuring seamless operations and high-quality care for our members.
Key Responsibilities- Implement strategies to improve provider performance and engagement
- Develop and maintain effective working relationships with the provider community
- Serve as a liaison between the company and providers to resolve questions or problems related to contract interpretation, product implementation, and claims administration
- Ensure provider compliance with company policies and contractual agreements
- Identify potential network participants and promote provider participation in Blue Shield of California programs and networks
- Conduct provider orientations and communicate company policies, procedures, products, or services
- Aid with provider negotiations and negotiate selected agreements
- Manage complex provider relationships and serve as the primary contact while demonstrating the ability to influence providers and build strong relationships
- Represent Network Management at internal meetings and present and communicate on behalf of Network Management to stakeholders and/or leadership
- Collaborate with various functional areas, influence providers, and cultivate business relationships with various constituents
- Requires a college degree or equivalent experience and a minimum of 7 years of prior relevant experience
- Requires excellent analytical and problem-solving skills
- Requires deep knowledge of the job area, typically obtained through advanced education combined with experience
- May have broad knowledge of project management
- Requires a minimum of 3 years of Provider Relations experience
- Requires experience in provider outreach
- Requires the ability to build strong relationships both internally and externally
- Requires strong written and verbal communication skills
- Knowledge of provider contracting process is preferred
- Experience of onboarding providers is preferred
- Ability to manage multiple projects is preferred
**Our Mission**
At Blue Shield of California, our mission is to ensure all Californians have access to high-quality healthcare at a sustainably affordable price. We are transforming healthcare in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.
**Our Values**
We hold ourselves to the highest ethical and integrity standards, building trust by doing what we say we're going to do and acknowledging and correcting where we fall short. We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.
**Our Workplace Model**
We are dedicated to making work-life balance a reality. Whether you prefer to work in an office or from home, we understand flexibility is more important than ever. That's why Blue Shield is a hybrid company, offering you the opportunity to decide where you can do your best and most meaningful work.
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