JOB DESCRIPTION

Get to know us!

Florida Blue, a GuideWell Company, has been providing insurance to residents of Florida for 75 years. Driven by its mission of helping people and communities achieve better health, the company serves more than five million healthcare members across the state.

We are looking for exceptional people who will bring our mission to life and succeed by putting the member first.

Let’s talk benefits!

When it comes to our benefits, we offer a total compensation package including competitive base pay, health insurance, 401(k), as well as work-life balance programs.

We design our offerings to take care of you to help you be your best at work and in life.

What you will do :

Provider Solutions Advisors provide provider services / network management support to the provider community by serving as a liaison between the provider and the Company on education, reimbursement, administrative / medical policy, and non-routine provider issues, by supporting network contracting by researching issues that may impact future provider negotiations or jeopardize network retention, and by assisting in the implementation of new initiatives, capabilities, and processes.

Important to Know

• Must reside in the Tampa, Florida Area
• Not 100% remote; 2-3 days a week is in the Field training, strategizing, building, and maintaining provider relationships
• Requires travel for client meetings, trainings, etc.

The essential functions listed represent the major duties of this role, additional duties may be assigned.

• Serves as an adviser and educator to providers as the health care industry transforms in order to impact improved performance outcomes.
• Influences key stakeholders to advocate for and adopt effective policies, business processes, initiatives, and capabilities.
• Monitors and evaluates adoption, engagement, and educational opportunities by analyzing data to positively influence outcomes.
• Coordinates solutions of critical non-resolved provider issues with internal business partners.
• Identifies and supports continuous improvement initiatives and provides subject matter expertise.
• Serves as mentor to lower-level Advisors.
• May create actions plans, tasks, scorecards and / or management plans.
• Contribute to the efficiency of the delivery system through offering and servicing a valued, integrated portfolio of business solutions.
• Support network contracting efforts by providing input on engagement / performance relative to network participation decisions and act as a conduit to share competitive intelligence, industry trends and environmental impacts to key business partners and stakeholders

What you will need

Experience :

• 4 years related work experience or equivalent combination of transferable experience and education, Health care experience with a focus in provider relationship, network management or provider office / hospital environments.
• Knowledge of all physician / provider payment and AFCS, methodologies / contracts, drug, per diem, OPP, DRG, etc.
• Experience with managing a territory and associated priorities, action plans and tasks.
• Experience with collaborating and building relationships with multiple internal and external partners such as vendors, providers, etc.
• Experience developing and implementing strategic plans.
• Knowledge of MS Office applications including Word, PowerPoint and Excel.
• Preparing and presenting training materials.
• Experience in negotiating and influencing customer outcomes.

Education :

Related Bachelor’s degree or additional related equivalent work experience in Health care with a focus on provider relationship, network management or provider office / hospital environments.

When you become part of the GuideWell family, you help bring our mission to life by helping people and communities achieve better health.

General Physical Demands :

Medium work : Exerting up to 50 pounds of force occasionally and / or up to 20 pounds of force frequently to move objects.

Physical / Environmental Activities

Must be able to travel to multiple locations for work (i.e., travel to attend meetings, events, conferences). Occasionally May be exposed to outdoor weather conditions of cold, heat, wet, and humidity.

Occasionally May be exposed to outdoor or warehouse conditions of loud noises, vibration, fumes, dust, odors, and mists.

Occasionally Must be able to ascend and descend ladders, stairs, or other equipment.

What We Offer :

As a Florida Blue employee, you will thrive in our Be Well, Work Well, GuideWell culture where being well as an individual, and working well as a team, are both important in serving our members and communities.

To support your wellbeing, comprehensive benefits are offered. As an employee, you will have access to :

• Medical, dental, vision, life and global travel health insurance;
• Income protection benefits : life insurance, Short- and long-term disability programs;
• Leave programs to support personal circumstances;
• Retirement Savings Plan includes employer contribution and employer match;
• Paid time off, volunteer time off, and 11 holidays
• Additional voluntary benefits available; and
• A comprehensive wellness program

Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed.

Benefits for intern, part-time and seasonal employees may differ.

To support your financial wellbeing, we offer competitive pay as well as opportunities for incentive or commission compensation.

We also conduct regular annual reviews with pay for performance considerations for base pay increases.

Annualized Salary Range : $62,500 - $101,500

Typical Annualized Hiring Range : $62,500 - $78,100

Final pay will be determined with consideration of market competitiveness, internal equity, and the job-related knowledge, skills, training, and experience you bring.

We are an Equal Opportunity / Protected Veteran / Disabled Employer committed to creating a diverse, inclusive, and equitable culture for our employees and communities.

Last updated : 2024-05-21