JOB SUMMARYThe Provider Relations Representative 1 is responsible for providing excellent customer service to providers, and providing timely and accurate responses to all provider concerns and issues. Responsible for delivering adequate training and education to providers for all product lines. Supports various operational management aspects of contracting and credentialing.ESSENTIAL FUNCTIONS OF THE ROLE
Develops and maintains trusting, personal relationships with providers and their office staff via office visits, telephone calls and correspondence. Meets weekly provider contact goals and provides excellent customer service during each contact. Serves as the liaison for providers and responds to all concerns and issues. Works with internal departments to ensure providers have a complete resolution.
Delivers adequate education and training to providers and their office staff for all product lines including, but not limited to, conducting new provider orientations.
Works with the Quality Improvement team on various HEDIS initiatives with the providers.
Facilitates information gathering for contract negotiations and reviews in order to expand provider networks and maximize cost effective care. Participates in and refers financial negotiations of hospital contracts to financial offices.
KEY SUCCESS FACTORS
Knowledge of managed care and/or health insurance industry.
Proven relationship management skills.
Able to negotiate and revise contracts in order to maximize cost effective care.
Proven problem-solving and data-based skills.
Able to collaborate on process definition and improvement and ensure quality standards are met.
Able to multi-task, set priorities, and work autonomously with minimal supervision.
Able to travel at least 40%-50% of the time Monday through Friday, including some overnight stay.
Excellent written and verbal communication skills.
BENEFITSOur benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include:
Immediate eligibility for health and welfare benefits
401(k) savings plan with dollar-for-dollar match up to 5%
Tuition Reimbursement
PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or levelQUALIFICATIONS
EDUCATION - Bachelor's or 4 years of work experience above the minimum qualification
EXPERIENCE - 1 Year of Experience
As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.