PROVIDER RELATIONS REPRESENTATIVE
ROLE AND RESPONSIBILITIES
The Provider Relations Representative (PR Rep) is responsible for managing the assigned Provider Network partnering with the Accountable Care Organization (ACO). This includes: facilitating provider communication, program implementation and conflict resolution functions. The PR Rep serves as a liaison between contracted payers, providers and ancillary providers to promote superior customer service and seamless programs.
We are looking for an individual to join our Provider Relations team who is motivated to provide best in class service for our Provider Groups and innovative solutions as we continue to grow and develop internal processes to meet our Provider Group’s needs and expectations. We strongly believe in the value of people and that this value will directly impact our relationship with our Provider Groups. We are a collaborative team and are looking for someone to make valuable contributions to our team’s vision.
Provider Group management - overall management of assigned Provider Groups; fostering an environment of strong positive relationships and process innovation
Proactively identify Provider Group’s needs, resolving and communicating concerns or complaints regarding ACO programs to maintain Provider Group satisfaction
Strategic planning with ACO to drive enrollment numbers for specific products for unique Provider Groups
Responsible for coordinating and facilitating all meetings with Provider Group’s Office Managers and Care Team trainings
Coordinate with the Director of Program Management to bring innovative processes, reporting, and communication integration for all Provider Groups
Identify opportunities for improved processes and Provider Group participation in established ACO programs
Assure that all Provider Group’s trainings, reporting, compliance and site visits are completed within established time frames.
Manage ongoing processes, new integration processes, Provider Relations strategic planning, utilization reporting
Continuous mindset toward efficiency and process improvement – how to apply technology and processes to improve delivery and efficiency from both the Provider Group and internal perspective
Oversee the maintenance of the Provider Relations database that includes all participating physicians and ancillary providers for the assigned territory
Complete all provider orientations and site visits within designated timeframes
Represent the organization well at all times; support its mission, goals and objectives; participate as a ‘team player”, constantly supporting other managers; set an example of high personal and professional conduct for employees and others
QUALIFICATIONS AND EDUCATION REQUIREMENTS
Associate’s Degree or equivalent work experience (Bachelor’s degree a plus)
1 years experience in a physician’s office or 3 years related experience in health care environment serving in a provider relations role
Experience in public speaking and/or group presentations.
Strong client focus (provide examples of success)
Value people; demonstrate professional respect and innovative mindset
Confident in working with heath care professionals
Passionate about your work and move forward with purpose; demonstrate clear value and support of your Provider Groups and internal teams
Exercise judgment in order to problem solve when the answer is not readily apparent
Approach problem solving that involves systems thinking and with a clear value of people – understanding how the whole process works and how people are impacted by your decisions from the Provider Group perspective and internally
Strong communication skills – understanding the need for being inclusive for effective results; communicate effectively with both day to day operational resources and executive management
Understand sense of urgency, fast-paced and multi-tasking environment; strong organizational skills
Solutions oriented mindset, willing to bring Provider Groups results regardless of roles or titles
Requires daily local travel to provider offices.(mileage reimbursement provided)
Willingness and ability to attend after hour business meetings as needed
Must maintain valid driver’s license and use personal vehicle for travel
Experience with basic Microsoft Office Applications