Senior Provider Relations Representative

at  Providence

DESCRIPTION

Under the supervision of the Senior Manager Provider Relations, this position is responsible for physician recruitment related activities and building relationships with Providence contracted physicians/specialist offices. Key responsibilities include Physician office in-services, continuous physician office education, fielding questions, researching and resolving inquiries, identifying issues, management and dissemination of network communications, identifying and vetting new PCP contract opportunities, and overall network performance. This position works with leadership to develop action plan for specific metrics/providers needing improvement, identifies PCP & SPC network gaps, and manages network performance meeting agenda and follow-ups. Activities of this role can impact the open enrollment period, and submission of documentation and recuperation of coding to improve Risk Adjusted Factors (RAF) scores.
Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Medical Foundation and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

REQUIRED QUALIFICATIONS:

• Upon request: Driving may be necessary as part of this role. Caregivers are required to comply with all state laws and requirements for driving. Caregivers will be expected to provide proof of driver license and auto insurance upon request. See policy for additional information.
• 3 years experience as a Provider Relations Representative working with physicians in a Managed Care/IPA, Medical Group, Health Plan or MSO environment.

PREFERRED QUALIFICATIONS:

• Bachelor’s Degree in Healthcare Management or related field.
• 5 years Managed care Provider Relations experience.

Please refer the Job description for details