Provider Relations Representative (Medicare Advantage/Managed Medicaid)

Provider Relations - Network Development Specialist

Remote

At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders - internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity and empower each other to illuminate our collective potential.

Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!

JOB SUMMARY

You can shine with us as a Provider Relations Specialist within our Government Programs Network Development team. This is a full-time (40 hours per week) remote position based in Texas. In this position you will visit Healthcare provider offices and provide education about the network programs and products. This position requires travel, which could require overnight stays and requires an active and valid Driver's License. Up to 70% travel within a geographic service area/territory, primarily to meet with providers on a frequent basis, and at times with little advance notice.

COMPENSATION

The salary range for this position is $58,000-$62,000 annually. Specific offers take into account a candidate's education, experience and skills, as well as the candidate's work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.

JOB ROLES AND RESPONSIBILITIES

• Meet with Healthcare Provider office staff providing education about Claritev programs and products.
• Cultivate and foster business relationships with contracted providers and their office administration staff.
• Distribute printed materials to Healthcare Provider office staff.
• Address and resolve Provider concerns and issues within established guidelines.
• Coordinate Provider education meetings (both in-person and virtual) as needed.
• Serve as an internal point of contact for network issue resolution originating from Customer Service calls and inquiries
• Track both the number and type of Provider visits and produce weekly visit report.
• Provide directions to providers, clients and members on processes as needed.
• Meet our quality, customer service, productivity and service level performance standards on a consistent basis

REQUIREMENTS

• Minimum bachelor's degree in related or applicable field, or HS Diploma (or GED) and four (4) years' experience related to network development
• Minimum 1-year experience in provider relations and network development, or equivalent provider/payer experience, successfully working with healthcare providers
• Valid Driver's License and access to dependable transportation
• Up to 70% travel within a geographic service area/territory, primarily to meet with providers on a frequent basis, and at times with little advance notice
• Knowledge of Healthcare office settings and Healthcare operations
• Strong oral, and written presentation skills and ability to interact with all levels of a provider organization
• Strong communication skills (written, verbal and listening), analytical, negotiation, business acumen, organization, strategic, multitasking and prioritization skills
• Ability to understand and explain government-sponsored payment methodologies
• Ability to research answers from multiple sources timely and effectively
• Ability to work efficiently in a fast-paced environment with competing priorities
• Ability to work from home effectively
• Ability to travel daily within geographic service area, as well as out of state travel to attend Claritev sponsored meetings, appropriate professional conferences or other business travel purposes.