Provider Relations Specialist
Provider Relations Specialist
We’re looking for colleagues who are ready to Think Big, Go Fast, Deliver Awe, and Win Together. These core values embody our diverse and inclusive culture and help us live out our mission of “getting people the care they need when they need it.” Over the last 30 years, our company has established itself as the market leader in managed care for the workers’ compensation industry. We are committed to making a positive impact in the lives of the injured workers we serve, and we have fun doing it.
Salary Range: 46,700.00 - 70,100.00 Salary
Salary may vary based on location, years of experience, qualifications, and skill set.
In return for your commitment to our company’s mission, we offer a vast array of benefits to help support the whole you.
- Opportunities to work from home
- Competitive wages with opportunities to earn annual merit increases
- Paid development hours to use for community development!
- Generous paid time off, 8 company holidays, and 2 floating holidays per year
- $1,000 Colleague Referral Program
- Enterprise Recognition Program rewarding colleagues for their extraordinary work
- Exclusive discounts on travel, activities, and merchandise via work discount program
- Colleague Assistance Program that provides free counseling and financial services
- Tuition Reimbursement Program including certifications
- Quantum Health: A healthcare navigation platform to help our colleagues make the best, most cost-effective healthcare decisions
- Medical, dental, and vision insurance
- Pre-Tax FSA and HSA health savings accounts
- 401(k) matching
- Company paid life insurance
- Company paid short term and long-term disability
- Referral program
- Healthcare concierge
- The One Call Foundation which aims to help colleagues during unexpected emergencies, from car accidents to natural disasters.
Develops and maintains relationships with providers, practitioners, practice managers, and other health care staff within a provider network. Serves as a point of contact between assigned care providers and the plan. Coordinates orientations and provides training to providers on the plan, its policies, and the benefits of joining the network. Assists providers in understanding their contracted agreements, and troubleshoots and resolves concerns with payments or denials. Ensures that provider information is accurately recorded in the plan's provider database. May conduct credentialing audits or site assessments as needed.
GENERAL DUTIES & RESPONSIBILITIES:
- Gain a deep understanding of One Call NEMT product and our provider partners
- Develop project plans for engaging and communicating with providers
- Build lasting relationships with providers
- Serve as a trusted resource and expert on many topics
- Use quantitative and qualitative data to identify ways to improve the product
- Partner with providers to optimize performance metrics
- Track your work diligently and carefully
- Communicate insights and updates to One Call leadership
- Incorporate feedback on your work to constantly iterate and improve
- Serve as the primary liaison between One Call and the participating provider community who service our members in Medicaid/Medicare product lines throughout the country
- Build and maintain strong relationships with providers by offering excellent customer service with routine and targeted education via in-person or virtual trainings for the purpose of continued education regarding policies/initiatives. Service also includes prompt follow up regarding contracting, credentialing, trip scheduling, claims, and other issues as presented
- Conduct on-site visits, telephonic conversations and written communications with individuals including providers, functional departments, and their leadership
- Perform on-site and virtual provider orientations and town hall meetings for new providers regarding policies, procedures, billing and company-wide initiatives
- Represent the Provider Relations Department in work groups and committees that address both internal and external customer concerns regarding the operations of One Call’s Group Health Transportation Provider Network
- Other duties as assigned
- Applicant must be highly proficient and creative at identifying and solving problems. Incumbent must be able to work independently as a telecommuter and attend off-site meetings; including overnight stays
- Willing and able to travel up to 25% in accordance with local pandemic prevention guidelines
- 1-3 years in account management, network management, sales, quality improvement, or other relevant experience at a fast-paced, data-driven company. Healthcare or Non-emergency Medical Transportation experience is strongly preferred. Direct experience working with patients and/or providers is a plus.
GENERAL KNOWLEDGE, SKILLS & ABILITIES:
- Skilled in influencing without always having authority
- Able to build trust quickly and develop relationships across all levels of client organization and within One Call
- Skilled in understanding others' perspectives and challenges
- Able to break down big challenges into organized plans
- Excellent interpersonal skills, oral and written communication skills
- Intellectually curious with a strong desire to understand a constantly improve your work and business processes
- Able to work cross functionally across remote teams
- Flexible and agile in ambiguous situations; open to changes in role and scope as the business grows
Work from Home
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