Provider Relations Representative jobs in Ohio

Provider Relations Representative supports, develops and maintains service relationships with all participants (physicians, providers and administrators) of a provider network. Responds to electronic and direct inquiries from clients about policies, rates, changes, referrals, eligibility, credentialing, etc. Typically requires a bachelor's degree. Being a Provider Relations Representative typically reports to a supervisor or manager. The Provider Relations Representative works on projects/matters of limited complexity in a support role. Work is closely managed. To be a Provider Relations Representative typically requires 0-2 years of related experience. (Copyright 2024 Salary.com)

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Manager, Provider Relations
  • CareSource
  • Columbus, OH FULL_TIME
  • Job Summary:

    The Manager, Provider Relations is responsible for overseeing and encouraging the collaboration with key Health Partners in the development of specific strategies for enhanced operational engagement.

    Essential Functions:

    • Oversee the ownership of the relationship with the Health Partner/Provider with a proactive focus on overall provider satisfaction and retention
    • Assists with the development and evolution of the team's strategic direction, annual goals and objectives, recommends new processes and changes for increased department productivity
    • Provide proactive, high-level account development and support in order to drive the overall satisfaction and engagement of key Health Partners/Providers
    • Ensure the training and development of Provider Relations Team to support provider relationships
    • Ensure the team's strategic objectives are met, both in creating new plans and in identifying and responding to customer needs
    • Establish and maintain strong working relationships with key internal business leaders
    • Ensure Provider Relations team members are resolving complex or non-routine questions, issues, and problems efficiently and effectively
    • Develop and report on key accomplishments and issues to leadership
    • Set targets and priorities to contribute towards meeting overall CareSource goals and strategies
    • Develop, implement and manage an onboarding and education escalation process
    • Outwardly support and communicate CareSource mission and goals
    • Contribute to the training and development of team members
    • Analyze current work processes, identify gaps and implement proactive, innovative approaches
    • Ensure appropriate documentation of interactions and projects by all team members
    • Perform any other job duties as requested

    Education and Experience:

    • Bachelor's Degree in Business Administration, or related field or equivalent years of relevant experience is required
    • Minimum of three (3) years of experience in the health plan/managed care industry is preferred
    • Previous Leadership experience is preferred

    Competencies, Knowledge and Skills:

    • Proficient with Microsoft Office to include Word, Excel and PowerPoint
    • Excellent written and verbal communications skills
    • Ability to develop, prioritize and accomplish goals
    • Detail oriented
    • Strong interpersonal skills and high level of professionalism
    • Effective listening and critical thinking skills
    • Effective problem-solving skills with attention to detail
    • Ability to work independently and within a team
    • Strong negotiation skills
    • Excellent leadership skills
    • Ability to create and maintain excellent working relationships

    Licensure and Certification:

    • Employment in this position is conditional pending successful clearance of a driver's license record check. If the driver's license record results are unacceptable, the offer will be withdrawn or, if you have started employment in this position, your employment in this position will be terminated
    • Six Sigma Certification or Project Management certification preferred

    Working Conditions:

    • General office environment; may be required to sit or stand for extended periods of time
    • 50% of time required for local travel
    • Mobile Worker: This is a mobile position, meaning that regular travel to different work locations is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time
    • May be required to travel greater than 50% of time to perform work duties. A valid driver's license, car, and insurance are necessary for work related travel
    • Required to use general office equipment, such as a telephone, photocopier, fax machine, and personal computer
    • Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our member and may refer members to other CareSource resources

    Compensation Range:
    $79,800.00 - $127,600.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.

    Compensation Type:
    Salary

    Competencies:
    - Create an Inclusive Environment - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business

    This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer, including disability and veteran status. We are committed to a diverse and inclusive work environment.


    CareSource is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to race, color, religion, sex, age, national origin, disability, sexual orientation, gender identity, genetic information, protected veteran status or any other characteristic protected by applicable federal, state or local law.

     

  • 5 Days Ago

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Provider Relations Specialist
  • Global Channel Management, Inc.
  • Mason, OH FULL_TIME
  • Company DescriptionGlobal Channel Management is a technology company that specializes in various types of recruiting and staff augmentation. Our account managers and recruiters have over a decade of e...
  • Just Posted

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Hospice Provider Relations
  • Crossroads Hospice & Palliative Care
  • Mentor, OH FULL_TIME
  • Provider Relations is a results-driven professional who supports the interdisciplinary hospice team by building relationships with doctors, facilities, and other healthcare organizations to obtain ref...
  • 1 Month Ago

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Manager - Provider Relations (Data)
  • EssilorLuxottica
  • Mason, OH FULL_TIME
  • Requisition ID: 843714 Position:Full-Time Total Rewards: Benefits/Incentive Information There’s more to EyeMed than meets the eye. EyeMed is the fastest growing managed vision benefits company in the ...
  • 17 Days Ago

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Manager - Provider Relations (Data)
  • EyeMed Vision Care
  • Mason, OH FULL_TIME
  • Requisition ID: 843714 Position:Full-Time Total Rewards: Benefits/Incentive Information There’s more to EyeMed than meets the eye. EyeMed is the fastest growing managed vision benefits company in the ...
  • 17 Days Ago

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Business Relations Representative
  • Telesystem
  • Northwood, OH FULL_TIME
  • For over 25 years, Telesystem has been empowering businesses across the country with a range of innovative network, communication and collaboration solutions designed to address the business-specific ...
  • 8 Days Ago

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Provider Relations Representative
  • American Health Plans
  • Boise, ID
  • American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Instituti...
  • 6/12/2024 12:00:00 AM

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Provider Relations Representative - Towson, MD (Hybrid)
  • Sheppard Pratt
  • Towson, MD
  • Since our founding in 1853, Sheppard Pratt has been transforming care and leading the way, creating a mental health cont...
  • 6/12/2024 12:00:00 AM

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Provider Relations Representative - Baton Rouge, LA
  • HMS
  • Baton Rouge, LA
  • Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances...
  • 6/12/2024 12:00:00 AM

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Provider Relations Representative
  • American Health Plans
  • Milledgeville, GA
  • American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Instituti...
  • 6/10/2024 12:00:00 AM

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Provider Relations Representative - Oxnard, CA
  • UnitedHealth Group
  • Oxnard, CA
  • Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. ...
  • 6/10/2024 12:00:00 AM

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Donor Relations Representative
  • Christus Health
  • Irving, TX
  • Description Summary: Responsible for gift processing and donor relations including: responding to all donor inquiries, r...
  • 6/10/2024 12:00:00 AM

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Guest Relations Representative
  • Six Flags Great Adventure
  • Jackson, NJ
  • Assist Guests with questions, comments, concerns they may have about their experience while visiting Six Flags. Resolve ...
  • 6/10/2024 12:00:00 AM

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Provider Relations Representative
  • Volunteers of America National Services
  • Volunteers of America National Services- PACE is seeking a Provider Relations Representative to service our Colorado Ser...
  • 6/8/2024 12:00:00 AM

Ohio /oʊˈhaɪoʊ/ (listen) is a Midwestern state in the Great Lakes region of the United States. Of the fifty states, it is the 34th largest by area, the seventh most populous, and the tenth most densely populated. The state's capital and largest city is Columbus. The state takes its name from the Ohio River, whose name in turn originated from the Seneca word ohiːyo', meaning "good river", "great river" or "large creek". Partitioned from the Northwest Territory, Ohio was the 17th state admitted to the Union on March 1, 1803, and the first under the Northwest Ordinance. Ohio is historically know...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Relations Representative jobs
$52,623 to $67,325