PROVIDER RELATIONS MANAGER I

  • Beacon Health Options
  • Rocky Hill, CT, USA
  • Jan 03, 2018
Medical

Job Description



Location
CT: Rocky Hill (500 Enterprise Drive, Suite 4D)

Job Family
Network Contracting and Provider Relations

Job Brief
The Provider Relations Manager I ensures compliance with the terms of the customer contract, provides support in the areas of facilitating resolution of provider issues or concerns, monitoring the provider network, support

Exempt

ABOUT THE POSITION

We are currently seeking a dynamic Provider Relations Manager I to join our team at our office in Rocky Hill, CT. The Provider Relations Manager I ensures compliance with the terms of the customer contract, provides support in the areas of facilitating resolution of provider issues or concerns, monitoring the provider network, support ongoing Provider Relations project management activities when requested and develop training materials for provider related training and/or Beacon Health Options staff.

Position Responsibilities:
  • Supports the provider relations department by managing provider relationships through practitioner and facility orientation, provider inquiries, training, attendance at meetings and participation in resolution of complaints as necessary
  • Answer practitioners/facility questions regarding enrollment, authorization and Beacon/Medicaid policies and procedures
  • Participate in the maintenance of provider files. Obtain, process, manage and maintain both hard-copy and computer based provider information necessary for network development and maintenance activities
  • Provide follow up with practitioners and facilities for the return of completed Provider Data Verification forms. Verify that provider information is current and updated in our database.Respond to providers' requests for enrollment and authorization information
  • Research and Problem Resolution: Perform research and problem resolution on issues related to provider complaints, authorizations reported to have been processed incorrectly, provider communications or verification of information as requested.Review and analyze provider information and status though database queries

Position Requirements:

Education: Bachelor's degree in human services or a related area is required. Master's degree in human services or a related area is preferred

Licensure: N/A

Relevant Work Experience: At least three years experience working in a customer service or provider relations/network operations role, preferably in a healthcare environment. Extensive experience with detail oriented projects, strong computer skills and training experience preferred

Knowledge, Skills & Abilities:
  • Excellent written and oral communication skills, flexibility, problem solving ability, creativity, teamwork skills, and prioritization skills required. Strong project management skills are a necessity. Exceptional computer skills, including Microsoft Office applications. Strong organizational, communication, analytical, aggregate and interpret data, present data findings, problem solving, and staff management skills are required

TO APPLY

Click below on "Apply for this Position" to create a profile and apply for the position

Beacon Health Options company is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled

AAP Reporting Location:

CT - Rocky Hill

ID (Req #):

53435

FTE Status:

Full Time

Schedule:

Mon-Fri 8:30-5:00

PI100670204