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Provider Relations Rep (North Central PA) - Hybrid at UPMC
DuBois, Pennsylvania, United States - Full Time
Skills Needed
Provider Relations, Healthcare, Managed Care, Communication Skills, Problem Solving, Behavioral Health, Organizational Skills, Team Collaboration, Client Education, Policy Knowledge, Service Delivery Standards, Action Planning, Newsletter Development, Credentialing, Authorization Process, Quality Indicators
Specialization
Candidates must have a B.A. or B.S. degree in a related field and at least 2 years of experience in a healthcare or managed care environment. Strong communication skills and knowledge of behavioral health systems are preferred.
Experience Required
Minimum 2 year(s)
Registered Nurse (RN) Overnight at Care Initiatives
Knoxville, Iowa, United States - Full Time
Skills Needed
Registered Nurse, Compassion, Healthcare, Patient Care, Cpr Certification, Long Term Care Regulations, Empathy, Respect, Patience, Discretion
Specialization
Candidates must have a valid RN license in good standing and current CPR certification. Knowledge of federal and state long-term care regulations is also required.
Registered Nurse (Weekends) at Care Initiatives
Kingsley, Iowa, United States - Full Time
Skills Needed
Registered Nurse, Compassion, Healthcare, Patient Care, Empathy, Respect, Cpr Certification, Long Term Care Regulations
Specialization
Candidates must have a valid RN license in good standing and current CPR certification. A strong commitment to helping others and knowledge of long-term care regulations is also required.
Manager, Care Team at Independent Living Systems
Ukiah, California, United States - Full Time
Skills Needed
Healthcare, Care Plans, Supervisory Skills, Problem Solving, Customer Service, Training, Compliance, Quality Metrics, Collaboration, Performance Management, Mentoring, Scheduling, Resource Allocation, Community Agencies, Medi Cal Eligibility, Bcls Cpr Certification
Specialization
Candidates must have a Bachelor's degree in a relevant field and at least 5 years of experience in healthcare, including 2 years in a supervisory role. A current nursing license or relevant certification is preferred, along with knowledge of community agencies and Medi-Cal guidelines.
Experience Required
Minimum 5 year(s)
Manager, Care Team at Independent Living Systems
Bakersfield, California, United States - Full Time
Skills Needed
Healthcare, Supervisory Skills, Care Coordination, Problem Solving, Customer Service, Training, Compliance, Performance Management, Team Management, Care Plans, Quality Improvement, Communication, Mentoring, Scheduling, Resource Allocation, Community Programs
Specialization
Candidates must have a Bachelor's degree in a relevant field and at least 5 years of experience in healthcare, including 2 years in a supervisory role. A current nursing license or relevant certification is preferred, along with strong problem-solving and customer service skills.
Experience Required
Minimum 5 year(s)
Manager, Care Team at Independent Living Systems
Susanville, California, United States - Full Time
Skills Needed
Healthcare, Care Coordination, Training, Supervision, Problem Solving, Customer Service, Compliance, Performance Management, Care Plans, Team Management, Quality Improvement, Communication, Mentoring, Scheduling, Resource Allocation, Patient Care
Specialization
Candidates must have a bachelor's degree in a relevant field and at least 5 years of experience in healthcare, including 2 years in a supervisory role. A current nursing license or relevant certification is preferred, along with knowledge of community agencies and Medi-Cal eligibility guidelines.
Experience Required
Minimum 5 year(s)
Manager, Care Team at Independent Living Systems
Willows, California, United States - Full Time
Skills Needed
Healthcare, Care Coordination, Training, Supervision, Problem Solving, Customer Service, Compliance, Performance Management, Care Plans, Team Management, Quality Improvement, Communication, Mentoring, Scheduling, Resource Allocation, Patient Care
Specialization
Candidates must have a bachelor's degree in a relevant field and at least 5 years of experience in healthcare, including 2 years in a supervisory role. A current nursing license or relevant certification is preferred, along with knowledge of community agencies and Medi-Cal eligibility guidelines.
Experience Required
Minimum 5 year(s)
Manager, Care Team at Independent Living Systems
, California, United States - Full Time
Skills Needed
Healthcare, Care Coordination, Training, Supervision, Problem Solving, Customer Service, Compliance, Performance Management, Care Plans, Quality Improvement, Team Management, Communication, Mentoring, Scheduling, Resource Allocation, Medi Cal
Specialization
Candidates must have a bachelor's degree in a relevant field and at least 5 years of experience in healthcare, including 2 years in a supervisory role. A current nursing license or relevant certification is preferred, along with knowledge of community agencies and Medi-Cal guidelines.
Experience Required
Minimum 5 year(s)
Manager, Care Team at Independent Living Systems
Bishop, California, United States - Full Time
Skills Needed
Healthcare, Care Coordination, Training, Supervision, Problem Solving, Customer Service, Compliance, Performance Management, Care Plans, Quality Improvement, Team Management, Communication, Mentoring, Scheduling, Resource Allocation, Community Agencies, Medi Cal
Specialization
Candidates must have a bachelor's degree in a relevant field and at least 5 years of experience in healthcare, including 2 years in a supervisory role. A current nursing license or relevant certification is preferred, along with knowledge of community agencies and Medi-Cal guidelines.
Experience Required
Minimum 5 year(s)
Constant Care Attendant at Providence Medical Grp.
Lubbock, Texas, United States - Full Time
Skills Needed
Patient Observation, Surveillance, Basic Microsoft Windows, Healthcare, Nursing Assistant, Home Health Aide, Personal Support Worker, Mental Health Support, Disability Support, Hospice, Palliative Care, Customer Service
Specialization
Candidates must have education to meet certification, license, or registration requirements, and upon hire, must obtain National Provider BLS certification from the American Heart Association. Basic Microsoft Windows experience is also required.
Registered Nurse Overnights at Care Initiatives
Chariton, Iowa, United States - Full Time
Skills Needed
Registered Nurse, Compassion, Healthcare, Cpr Certification, Long Term Care Regulations, Empathy, Respect, Patience, Discretion
Specialization
Candidates must have a valid RN license in good standing and current CPR certification. Knowledge of federal and state long-term care regulations is also required.
Talent Acquisition Strategic Sourcer (Remote) at Nuclear Care Partners
Lowell, Massachusetts, United States - Full Time
Skills Needed
Sourcing, Recruiting, Healthcare, Linkedin, Boolean Search, Ats, Organized, Proactive, Communication, Pipeline Development, Market Research, Outreach, Candidate Relationships, High Volume Hiring, Geo Targeted Sourcing, Personalized Outreach
Specialization
Candidates should have at least 2 years of sourcing or recruiting experience, preferably in healthcare. Strong LinkedIn sourcing and Boolean search skills are essential, along with experience using ATS and sourcing tools.
Experience Required
Minimum 2 year(s)
RN - Floor Staff Overnights at Care Initiatives
Corning, Iowa, United States - Full Time
Skills Needed
Registered Nurse, Compassion, Healthcare, Patient Care, Cpr Certification, Long Term Care Regulations, Empathy, Respect, Patience, Discretion
Specialization
Candidates must have a valid RN license in good standing and current CPR certification. Knowledge of federal and state long-term care regulations is also required.
Registered Nurse (RN) Mobile & Flexible (State Center) at Care Initiatives
State Center, Iowa, United States - Full Time
Skills Needed
Registered Nurse, Cpr Certification, Patient Care, Flexible Schedule, Teamwork, Compassion, Communication, Travel, Nursing, Healthcare
Specialization
Candidates must have an active Iowa RN license and CPR certification, along with twelve months of verifiable RN experience. The ability to travel between multiple locations is also required.
Experience Required
Minimum 2 year(s)
Registered Nurse Overnight (RN Monday-Thursday) at Care Initiatives
Centerville, Iowa, United States - Full Time
Skills Needed
Registered Nurse, Compassion, Healthcare, Cpr Certification, Long Term Care Regulations, Empathy, Respect, Patience, Discretion
Specialization
Candidates must have a valid RN license in good standing within the state of Iowa and current CPR certification. A strong commitment to helping others with empathy and respect is essential.
Correctional Dentist - Stiles Unit at University of Texas Medical Branch (UTMB)
Beaumont, Texas, United States - Full Time
Skills Needed
Dental Care, Patient Care, Clinical Practice, Independent Judgement, Healthcare, Correctional Facility, Texas Dentistry, Bls Hp, Dea Registration
Specialization
Candidates must be licensed to practice dentistry in Texas and hold a current DEA registration certificate. A minimum of two years of general clinical practice is preferred.
Experience Required
Minimum 2 year(s)
Registered Nurse 6PM - 6AM (No Weekends) at Care Initiatives
Creston, Iowa, United States - Full Time
Skills Needed
Registered Nurse, Compassion, Healthcare, Patient Care, Cpr Certification, Long Term Care Regulations, Empathy, Respect, Patience, Discretion
Specialization
Candidates must have a valid RN license in good standing within the state of Iowa and current CPR certification. A strong commitment to helping others with empathy and respect is essential.
Service Coordinator- Southeast, PA (Hybrid with travel in Southeast PA and at UPMC
Philadelphia, Pennsylvania, United States - Full Time
Skills Needed
Service Coordination, Healthcare, Community Resources, Case Management, Assessment, Person Centered Service Planning, Long Term Services, Medicaid, Medicare, Cultural Competency, Communication, Monitoring, Compliance, Confidentiality, Transportation, Administrative Duties
Specialization
Candidates should have a bachelor's degree in social work, psychology, or related fields, or at least three years of experience in a social service or healthcare setting. Preferred experience includes working with individuals with disabilities or seniors in need of long-term services and supports.
Experience Required
Minimum 2 year(s)
Direct Support Professional (PRN) at American Baptist Homes of the Midwest
Ottumwa, Iowa, United States - Full Time
Skills Needed
Compassion, Communication, Dependability, Detail Oriented, Caregiving, Healthcare, Monitoring, Collaboration
Specialization
Applicants must be 21 or older and have a valid driver's license and insurance. Experience in a medical, caregiving, or healthcare setting is preferred but not required.
Program Coordinator at Woodlands Senior Living of Bridgton LLC
Rockland, Maine, United States - Full Time
Skills Needed
Administration, Healthcare, Staff Coordination, Training, Mentoring, Performance Evaluation, Resident Services, Quality Assessment, Care Monitoring, Service Plan Coordination, Complaint Reporting, Communication, Problem Solving, Teamwork, Customer Service, Time Management
Specialization
Candidates must be at least 18 years old and hold a current Certified Residential Medication Aide (CRMA) certification. Additional requirements include proof of immunizations and a valid driver's license.
Provider Relations Rep (North Central PA) - Hybrid at UPMC
DuBois, Pennsylvania, United States -
Full Time


Start Date

Immediate

Expiry Date

20 Mar, 26

Salary

0.0

Posted On

20 Dec, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Provider Relations, Healthcare, Managed Care, Communication Skills, Problem Solving, Behavioral Health, Organizational Skills, Team Collaboration, Client Education, Policy Knowledge, Service Delivery Standards, Action Planning, Newsletter Development, Credentialing, Authorization Process, Quality Indicators

Industry

Hospitals and Health Care

Description
UPMC Community Care Behavioral Health is hiring a full-time Provider Relations Representative to support the Network Management team. This position follows a hybrid schedule, requiring in-office presence a few days per week. Candidates may work from any of the following office locations: Dubois, Moosic, or Clearfield. Occasional travel may be required, though this will be rare. This position will initiate and develop working relationships with external providers. They will manage the primary caseload of assigned providers for whom he/she is the principal point of contact, and cover other caseloads from time-to-time as circumstances require. Assure that the provider is fully educated as to appropriate policies and procedures for conducting business with Community Care. Present comprehensive knowledge of the authorizations and claims functions, credentialing requirements, the application and contracting process, and other topics of general and specific interest to the provider. Adequately, be well versed in the differences between the commercial, Medical Assistance and all other products, with an emphasis on differences in the providers' obligations for each. Responsibilities: Assure that providers meet the clinical needs of enrolled consumers while continuing to comply with service delivery standards. Share responsibilities with other department personnel for answering the provider line. Establish excellent working relationships with a defined panel of providers. Work with the Director, Provider Relations and other staff as appropriate to develop the provider manuals and handbooks; this process will involve provider input as well as advice from appropriately designated advisory groups. Develop and implement an Action Plan in response to each provider service call. Participate in development and delivery of provider orientation and for follow-up as needed with assigned group. Work with colleagues on development of provider newsletter and other educational materials. Assure that assigned providers have current copies of all relevant educational materials, including the billing handbook and provider manual; is responsible for accurate interpretation of materials to providers in a consistent fashion and for identifying and proposing solutions to problems as they arise. Work as member of the Provider Relations staff, ensure that corrective action plans are implemented and result in complete problem resolution. Responsive to deadlines; complete assignments within deadlines at least 95%25 of the time. Meet or exceed specified goals for the number of provider service meetings on a quarterly basis. Balance time and effort spent on external provider servicing with in-office responsibilities. Coordinate service schedule with other Service Reps to ensure adequate and consistent phone coverage. Implement use of quality indicators for use within the network, including work with providers as necessary to assure full understanding and compliance. Manage supplemental service enrollment process for his/her designated panel of providers. Understand and communicates the details of the authorization process and Community Care's procedures for delivering the authorizations to providers. B.A .or B.S. degree in a healthcare, human services or related field. 2 years of experience working in a complex organizational environment. 2 years of experience in healthcare or managed care environment. Drivers license strongly preferred. Experience as a provider of behavioral health services and/or knowledge of behavioral health provider system preferred. Excellent written and oral communication skills. Must clearly and consistently articulate standards of care and specifics of the various provider agreements. Independent problem-solving skills, including the ability to address issues in a timely and accurate manner. Knowledge of public and private delivery systems in behavioral health care. Licensure, Certifications, and Clearances: UPMC is an Equal Opportunity Employer/Disability/Veteran
Responsibilities
The Provider Relations Representative will initiate and develop relationships with external providers, manage a primary caseload, and ensure providers are educated on policies and procedures. They will also participate in the development of provider manuals and handle service calls effectively.
Provider Relations Rep (North Central PA) - Hybrid at UPMC
DuBois, Pennsylvania, United States - Full Time
Skills Needed
Provider Relations, Healthcare, Managed Care, Communication Skills, Problem Solving, Behavioral Health, Organizational Skills, Team Collaboration, Client Education, Policy Knowledge, Service Delivery Standards, Action Planning, Newsletter Development, Credentialing, Authorization Process, Quality Indicators
Specialization
Candidates must have a B.A. or B.S. degree in a related field and at least 2 years of experience in a healthcare or managed care environment. Strong communication skills and knowledge of behavioral health systems are preferred.
Experience Required
Minimum 2 year(s)
Registered Nurse (RN) Overnight at Care Initiatives
Knoxville, Iowa, United States - Full Time
Skills Needed
Registered Nurse, Compassion, Healthcare, Patient Care, Cpr Certification, Long Term Care Regulations, Empathy, Respect, Patience, Discretion
Specialization
Candidates must have a valid RN license in good standing and current CPR certification. Knowledge of federal and state long-term care regulations is also required.
Registered Nurse (Weekends) at Care Initiatives
Kingsley, Iowa, United States - Full Time
Skills Needed
Registered Nurse, Compassion, Healthcare, Patient Care, Empathy, Respect, Cpr Certification, Long Term Care Regulations
Specialization
Candidates must have a valid RN license in good standing and current CPR certification. A strong commitment to helping others and knowledge of long-term care regulations is also required.
Manager, Care Team at Independent Living Systems
Ukiah, California, United States - Full Time
Skills Needed
Healthcare, Care Plans, Supervisory Skills, Problem Solving, Customer Service, Training, Compliance, Quality Metrics, Collaboration, Performance Management, Mentoring, Scheduling, Resource Allocation, Community Agencies, Medi Cal Eligibility, Bcls Cpr Certification
Specialization
Candidates must have a Bachelor's degree in a relevant field and at least 5 years of experience in healthcare, including 2 years in a supervisory role. A current nursing license or relevant certification is preferred, along with knowledge of community agencies and Medi-Cal guidelines.
Experience Required
Minimum 5 year(s)
Manager, Care Team at Independent Living Systems
Bakersfield, California, United States - Full Time
Skills Needed
Healthcare, Supervisory Skills, Care Coordination, Problem Solving, Customer Service, Training, Compliance, Performance Management, Team Management, Care Plans, Quality Improvement, Communication, Mentoring, Scheduling, Resource Allocation, Community Programs
Specialization
Candidates must have a Bachelor's degree in a relevant field and at least 5 years of experience in healthcare, including 2 years in a supervisory role. A current nursing license or relevant certification is preferred, along with strong problem-solving and customer service skills.
Experience Required
Minimum 5 year(s)
Manager, Care Team at Independent Living Systems
Susanville, California, United States - Full Time
Skills Needed
Healthcare, Care Coordination, Training, Supervision, Problem Solving, Customer Service, Compliance, Performance Management, Care Plans, Team Management, Quality Improvement, Communication, Mentoring, Scheduling, Resource Allocation, Patient Care
Specialization
Candidates must have a bachelor's degree in a relevant field and at least 5 years of experience in healthcare, including 2 years in a supervisory role. A current nursing license or relevant certification is preferred, along with knowledge of community agencies and Medi-Cal eligibility guidelines.
Experience Required
Minimum 5 year(s)
Manager, Care Team at Independent Living Systems
Willows, California, United States - Full Time
Skills Needed
Healthcare, Care Coordination, Training, Supervision, Problem Solving, Customer Service, Compliance, Performance Management, Care Plans, Team Management, Quality Improvement, Communication, Mentoring, Scheduling, Resource Allocation, Patient Care
Specialization
Candidates must have a bachelor's degree in a relevant field and at least 5 years of experience in healthcare, including 2 years in a supervisory role. A current nursing license or relevant certification is preferred, along with knowledge of community agencies and Medi-Cal eligibility guidelines.
Experience Required
Minimum 5 year(s)
Manager, Care Team at Independent Living Systems
, California, United States - Full Time
Skills Needed
Healthcare, Care Coordination, Training, Supervision, Problem Solving, Customer Service, Compliance, Performance Management, Care Plans, Quality Improvement, Team Management, Communication, Mentoring, Scheduling, Resource Allocation, Medi Cal
Specialization
Candidates must have a bachelor's degree in a relevant field and at least 5 years of experience in healthcare, including 2 years in a supervisory role. A current nursing license or relevant certification is preferred, along with knowledge of community agencies and Medi-Cal guidelines.
Experience Required
Minimum 5 year(s)
Manager, Care Team at Independent Living Systems
Bishop, California, United States - Full Time
Skills Needed
Healthcare, Care Coordination, Training, Supervision, Problem Solving, Customer Service, Compliance, Performance Management, Care Plans, Quality Improvement, Team Management, Communication, Mentoring, Scheduling, Resource Allocation, Community Agencies, Medi Cal
Specialization
Candidates must have a bachelor's degree in a relevant field and at least 5 years of experience in healthcare, including 2 years in a supervisory role. A current nursing license or relevant certification is preferred, along with knowledge of community agencies and Medi-Cal guidelines.
Experience Required
Minimum 5 year(s)
Constant Care Attendant at Providence Medical Grp.
Lubbock, Texas, United States - Full Time
Skills Needed
Patient Observation, Surveillance, Basic Microsoft Windows, Healthcare, Nursing Assistant, Home Health Aide, Personal Support Worker, Mental Health Support, Disability Support, Hospice, Palliative Care, Customer Service
Specialization
Candidates must have education to meet certification, license, or registration requirements, and upon hire, must obtain National Provider BLS certification from the American Heart Association. Basic Microsoft Windows experience is also required.
Registered Nurse Overnights at Care Initiatives
Chariton, Iowa, United States - Full Time
Skills Needed
Registered Nurse, Compassion, Healthcare, Cpr Certification, Long Term Care Regulations, Empathy, Respect, Patience, Discretion
Specialization
Candidates must have a valid RN license in good standing and current CPR certification. Knowledge of federal and state long-term care regulations is also required.
Talent Acquisition Strategic Sourcer (Remote) at Nuclear Care Partners
Lowell, Massachusetts, United States - Full Time
Skills Needed
Sourcing, Recruiting, Healthcare, Linkedin, Boolean Search, Ats, Organized, Proactive, Communication, Pipeline Development, Market Research, Outreach, Candidate Relationships, High Volume Hiring, Geo Targeted Sourcing, Personalized Outreach
Specialization
Candidates should have at least 2 years of sourcing or recruiting experience, preferably in healthcare. Strong LinkedIn sourcing and Boolean search skills are essential, along with experience using ATS and sourcing tools.
Experience Required
Minimum 2 year(s)
RN - Floor Staff Overnights at Care Initiatives
Corning, Iowa, United States - Full Time
Skills Needed
Registered Nurse, Compassion, Healthcare, Patient Care, Cpr Certification, Long Term Care Regulations, Empathy, Respect, Patience, Discretion
Specialization
Candidates must have a valid RN license in good standing and current CPR certification. Knowledge of federal and state long-term care regulations is also required.
Registered Nurse (RN) Mobile & Flexible (State Center) at Care Initiatives
State Center, Iowa, United States - Full Time
Skills Needed
Registered Nurse, Cpr Certification, Patient Care, Flexible Schedule, Teamwork, Compassion, Communication, Travel, Nursing, Healthcare
Specialization
Candidates must have an active Iowa RN license and CPR certification, along with twelve months of verifiable RN experience. The ability to travel between multiple locations is also required.
Experience Required
Minimum 2 year(s)
Registered Nurse Overnight (RN Monday-Thursday) at Care Initiatives
Centerville, Iowa, United States - Full Time
Skills Needed
Registered Nurse, Compassion, Healthcare, Cpr Certification, Long Term Care Regulations, Empathy, Respect, Patience, Discretion
Specialization
Candidates must have a valid RN license in good standing within the state of Iowa and current CPR certification. A strong commitment to helping others with empathy and respect is essential.
Correctional Dentist - Stiles Unit at University of Texas Medical Branch (UTMB)
Beaumont, Texas, United States - Full Time
Skills Needed
Dental Care, Patient Care, Clinical Practice, Independent Judgement, Healthcare, Correctional Facility, Texas Dentistry, Bls Hp, Dea Registration
Specialization
Candidates must be licensed to practice dentistry in Texas and hold a current DEA registration certificate. A minimum of two years of general clinical practice is preferred.
Experience Required
Minimum 2 year(s)
Registered Nurse 6PM - 6AM (No Weekends) at Care Initiatives
Creston, Iowa, United States - Full Time
Skills Needed
Registered Nurse, Compassion, Healthcare, Patient Care, Cpr Certification, Long Term Care Regulations, Empathy, Respect, Patience, Discretion
Specialization
Candidates must have a valid RN license in good standing within the state of Iowa and current CPR certification. A strong commitment to helping others with empathy and respect is essential.
Service Coordinator- Southeast, PA (Hybrid with travel in Southeast PA and at UPMC
Philadelphia, Pennsylvania, United States - Full Time
Skills Needed
Service Coordination, Healthcare, Community Resources, Case Management, Assessment, Person Centered Service Planning, Long Term Services, Medicaid, Medicare, Cultural Competency, Communication, Monitoring, Compliance, Confidentiality, Transportation, Administrative Duties
Specialization
Candidates should have a bachelor's degree in social work, psychology, or related fields, or at least three years of experience in a social service or healthcare setting. Preferred experience includes working with individuals with disabilities or seniors in need of long-term services and supports.
Experience Required
Minimum 2 year(s)
Direct Support Professional (PRN) at American Baptist Homes of the Midwest
Ottumwa, Iowa, United States - Full Time
Skills Needed
Compassion, Communication, Dependability, Detail Oriented, Caregiving, Healthcare, Monitoring, Collaboration
Specialization
Applicants must be 21 or older and have a valid driver's license and insurance. Experience in a medical, caregiving, or healthcare setting is preferred but not required.
Program Coordinator at Woodlands Senior Living of Bridgton LLC
Rockland, Maine, United States - Full Time
Skills Needed
Administration, Healthcare, Staff Coordination, Training, Mentoring, Performance Evaluation, Resident Services, Quality Assessment, Care Monitoring, Service Plan Coordination, Complaint Reporting, Communication, Problem Solving, Teamwork, Customer Service, Time Management
Specialization
Candidates must be at least 18 years old and hold a current Certified Residential Medication Aide (CRMA) certification. Additional requirements include proof of immunizations and a valid driver's license.
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