Job Description:

Provider Relations Specialist - Phila., PA

Homestead Smart Health Plans has an immediate opening for an 'experienced', organized, and detail-oriented Provider Relations Specialist.

Job Overview:

The Provider Relations Specialist is responsible for the full range of provider relations and service interactions with the Health Plan, including working to remedy end-to-end provider issues, use of provider portal and negotiation and contracting efforts.

It is imperative that this individual be proficient in relationship development and comfortable interacting with not just Providers, but Members as well.

We are a team that places great emphasis on positively impacting the member experience.

The Provider Relations Specialist will act as the liaison and be the main point of contact on the Members’ behalf.

The Provider Relations Specialist will need to utilize the necessary software to complete their everyday responsibilities. Examples of these additional tools are: Dialpad, Zendesk, and use of the provider portal.

The position is Full Time and Permanent and is located in Philadelphia, PA. We are currently working in a hybrid environment (3 days in the office, 2 days working from home).

Specific Job Responsibilities include:

* Assist with locating Providers and contacting them on behalf of the member to streamline appointment scheduling.

* Conduct Provider education calls and actively participate in the Provider negotiation (pre/post service), contracting, and single payment agreement process.

* Investigate and respond to provider inquiries and other complex issues as needed.

* Work independently in the pursuit of these responsibilities.

* Ensure all provider information is accurate and up to date for claims payment.

* Adhere to the SPA (Single Case Agreement) time preparation guidelines and member communications that are outlined in our policies and procedures.

* Maintain adherence to policies around entering SPA’s and contracts into our system.

* Assist in cross-training and interdepartmental initiatives.

* Perform other related duties and projects as assigned.

Homestead Smart Health Plans is an Affirmative Action - Equal Opportunity Employer (Minorities/Females/Vets/Disabled). Homestead provides equal opportunities to all employees and applicants for employment without regard to sex, race, color, religion, marital status, national origin, age, genetic information, sexual orientation, gender (including gender identity/expression), disability, veteran status and military status, pregnancy or pregnancy-related medical conditions, or any other factor that may be protected by law