Recent Searches

You haven't searched anything yet.

1 Provider Relations Representative Job in Santa Rosa, CA

SET JOB ALERT
Details...
Partnership HealthPlan of California
Santa Rosa, CA | Full Time
$64k-80k (estimate)
7 Months Ago
Provider Relations Representative
$64k-80k (estimate)
Full Time 7 Months Ago
Save

sadSorry! This job is no longer available. Please explore similar jobs listed on the left.

Partnership HealthPlan of California is Hiring a Provider Relations Representative Near Santa Rosa, CA

Overview

To establish and maintain excellent relationships with the provider network in a specific geographic region, including healthcare practitioners, office staff, and administrators. Works closely to identify and resolve complex issues, provides education and staff training. Provides service and education via onsite visits and telephone. Assists providers with understanding Partnership HealthPlan of California's policies and procedures and assists with resolving issues that arise.

Responsibilities

  • Maintains regular schedule of provider office visits to ensure open lines of communication, answers questions, distributes information, and documents and follows-up on questions or concerns. Ensures each visit includes a well-documented Rep Visit Sheet.
  • Investigates and responds to provider concerns. Serves as neutral liaison between providers and PHC departments in responding to questions and resolving issues. Assists with research and disposition of provider appeals and grievances.
  • Trains provider offices via onsite visits and by telephone regarding PHC policies, procedures, and available resources.
  • Creates educational materials and formal presentations.
  • Conducts provider orientations and ongoing educational training sessions. Assists with meeting coordination to ensure agendas are distributed timely and materials and other required arrangements are prepared.
  • Educates providers on the use of PHC provider information forms. Follows up with providers on incomplete forms to obtain required information.
  • Resolve complex authorization or claims issues. Identify potential system issues, collaborate with affected departments to ensure resolution.
  • Conducts monthly, quarterly, annual and ad hoc provider surveys.
  • Creates Corrective Action Plans (CAPS) for provider sites that did not meet standards. Monitors compliance with CAP.
  • Uses databases and tracking systems to document and retrieve information and run reports.
  • Composes correspondence, conducts research, and prepares reports.
  • Coordinates, attends, and participates in various meetings both on and off-site as assigned.
  • May be required to report on major points, resolved and pending action items.
  • Required to work with minimal supervision.
  • Other duties as assigned.

Qualifications

Education and Experience

Bachelor’s degree in health care administration, business, or public relations preferred, or equivalent combination of education and experience; prior experience with physician offices or managed care or health insurance environment preferred.

Special Skills,

Licenses and

Certifications

Excellent oral and written communication and presentation skills. Excellent organizational, prioritizing, and multi-tasking skills required. Ability to use good judgment in making decisions within scope of authority and handle sensitive issues with tact and diplomacy. Proficient in Microsoft Office (Word, PowerPoint, Excel). Ability to use a variety of databases for research and entry of information. Valid California driver’s license and proof of current automobile insurance compliant with PHC policy are required to operate a vehicle and travel for company business.

Performance

Based

Competencies

Must be able to work in a fast-paced environment and maintain courtesy and composure. Ability to function effectively with frequent interruptions.

Work Environment

And Physical

Demands

At least 50% of work time is spent driving and more than 30% of work time is spent in front of a computer monitor. Ability to lift, carry or move objects of varying size, weighing up to 25 lbs.

All HealthPlan employees are expected to:

  • Provide the highest possible level of service to clients;
  • Promote teamwork and cooperative effort among employees;
  • Maintain safe practices; and
  • Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.

 HIRING RANGE:

$57,050.52 - $74,164.68

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Job Summary

JOB TYPE

Full Time

SALARY

$64k-80k (estimate)

POST DATE

08/09/2022

EXPIRATION DATE

05/31/2023

WEBSITE

partnershiphp.org

HEADQUARTERS

Fairfield, CA

SIZE

1,000 - 3,000

Show more

Partnership HealthPlan of California
Full Time
$127k-159k (estimate)
1 Day Ago
Partnership HealthPlan of California
Full Time
$85k-107k (estimate)
2 Weeks Ago
Partnership HealthPlan of California
Full Time
$177k-224k (estimate)
2 Weeks Ago

The job skills required for Provider Relations Representative include Managed Care, Presentation, Microsoft Office, Written Communication, Health Insurance, PowerPoint, etc. Having related job skills and expertise will give you an advantage when applying to be a Provider Relations Representative. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Provider Relations Representative. Select any job title you are interested in and start to search job requirements.

For the skill of  Managed Care
Medical Professionals
Full Time
$43k-53k (estimate)
2 Weeks Ago
For the skill of  Presentation
Robert Half
Other
$83k-106k (estimate)
Just Posted
For the skill of  Microsoft Office
Connect Staffing
Full Time
$78k-101k (estimate)
Just Posted
Show more

The following is the career advancement route for Provider Relations Representative positions, which can be used as a reference in future career path planning. As a Provider Relations Representative, it can be promoted into senior positions as a Provider Relations Representative, Sr. that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Provider Relations Representative. You can explore the career advancement for a Provider Relations Representative below and select your interested title to get hiring information.