Provider Training Specialist

3 weeks ago

Marquand, Missouri, United States CenterWell Home Health Full time
Join a compassionate community dedicated to prioritizing health

CenterWell Home Health is looking for a Provider Education & Outreach Representative. This role is essential for managing the daily relationships with network providers, focusing on onboarding, training, and addressing provider inquiries while resolving any issues or complaints.

The Provider Education & Outreach Representative will focus on supporting Long-Term Services and Supports (LTSS) and Home and Community-Based Services (HCBS) providers, as well as Physical Health (PH) and Behavioral Health (BH) providers.

Key Responsibilities:

  • Conduct regular meetings, both in-person and virtually, with assigned providers to deliver training and education, ensuring comprehension of policies and procedures.
  • Act as the primary relationship manager for LTSS and HCBS providers and/or PH and BH providers, ensuring a positive experience and promoting network retention.
  • Assist new providers with onboarding, including orientation sessions.
  • Address provider inquiries promptly and ensure resolution of issues with relevant business teams, covering claims payment, prior authorizations, and referrals.
  • Organize Joint Operating Committee meetings with providers, preparing agendas and materials to discuss operational, clinical, and quality topics.

Utilize your expertise to create a meaningful impact

Required Qualifications:

  • Must reside in the state of Indiana and be available to work in the office a few days each week.
  • Ability to travel (up to 15%) within Indiana to provider offices and company locations.
  • Minimum of 2 years of experience in healthcare or managed care, specifically in provider relations or claims education.
  • Experience with LTSS and HCBS providers and/or PH and BH providers.
  • Background in healthcare administration.
  • Knowledge of claims systems, adjudication, submission processes, and coding.
  • Strong analytical skills to communicate complex issues effectively.
  • Excellent time management abilities and capacity to handle multiple priorities in a dynamic environment.
  • Proficient in Microsoft Office applications, including Word, Excel, Outlook, and PowerPoint.
  • Valid state driver's license and proof of personal vehicle liability insurance are required.
  • Participation in a tuberculosis (TB) screening program is mandatory for this role.

Preferred Qualifications:

  • Bachelor's Degree.
  • Familiarity with Indiana Medicaid and Medicare Advantage guidelines.
  • Understanding of managed care contracts and reimbursement processes.
  • Comprehensive knowledge of claims systems and dispute resolution.

Work Environment:

  • Hybrid work model, requiring in-office presence a few days each week.
  • Up to 15% travel within Indiana.
  • Core working hours are Monday to Friday, 8:00 AM to 5:00 PM EST/CST.
  • Comprehensive benefits package effective from day one, including medical, dental, vision, and retirement savings plans.

About CenterWell Home Health:

CenterWell Home Health is committed to enhancing the health and well-being of our communities. Through our dedicated services, we strive to provide the necessary care and support to individuals and families, ensuring they receive the best possible health outcomes.

Equal Opportunity Employer:

CenterWell Home Health is an equal opportunity employer and does not discriminate against any employee or applicant based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or veteran status.

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