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Provider Relations Specialist

Company: One Call
Location: San Antonio
Posted on: November 22, 2021

Job Description:

Provider Relations Specialist - Corpus Christi, TX or San Antonio, TX Location: Corpus Christi, Texas or San Antonio, Texas Develops and maintains relationships with providers, practitioners, practice managers, and other health care staff within a provider network. Serves as a point of contact between assigned care providers and the plan. Coordinates orientations and provides training to providers on the plan, its policies, and the benefits of joining the network. Assists providers in understanding their contracted agreements, a nd troubleshoots and resolves concerns with payments or denials. Ensures that provider information is accurately recorded in the plan's provider database. May conduct credentialing audits or site assessments as needed. Job Requirements:GENERAL DUTIES & RESPONSIBILITIES: Gain a deep understanding of One Call Non-Emergency Medical Transportation (NEMT) product and our provider partners Develop project plans for engaging and communicating with providers Build lasting relationships with providers Serve as a trusted resource and expert on many topics Use quantitative and qualitative data to identify ways to improve the product Partner with providers to optimize performance metrics Track your work diligently and carefully Communicate insights and updates to One Call leadership Incorporate feedback on your work to constantly iterate and improve Serve as the primary liaison between One Call and the participating provider community who service our members in Medicaid/Medicare product lines throughout the country Build and maintain strong relationships with providers by offering excellent customer service with routine and targeted education via in-person or virtual trainings for the purpose of continued education regarding policies/initiatives. Service also includes prompt follow up regarding contracting, credentialing, trip scheduling, claims, and other issues as presented Conduct on-site visits, telephonic conversations and written communications with individuals including providers, functional departments, and their leadership Perform on-site and virtual provider orientations and town hall meetings for new providers regarding policies, procedures, billing and company-wide initiatives Represent the Provider Relations Department in work groups and committees that address both internal and external customer concerns regarding the operations of One Call's Group Health Transportation Provider Network Other duties as assigned Applicant must be highly proficient and creative at identifying and solving problems. Incumbent must be able to work independently as a telecommuter and attend off-site meetings; including overnight stays Willing and able to travel up to 25% in accordance with local pandemic prevention guidelines EDUCATIONAL REQUIREMENTS:

  • 1-3 years in account management, network management, sales, quality improvement, or other relevant experience at a fast-paced, data-driven company. Healthcare or Non-emergency Medical Transportation experience is strongly preferred. Direct experience working with patients and/or providers is a plus. GENERAL KNOWLEDGE, SKILLS & ABILITIES:
  • Skilled in influencing without always having authority
  • Able to build trust quickly and develop relationships across all levels of client organization and within One Call
  • Skilled in understanding others' perspectives and challenges
  • Able to break down big challenges into organized plans
  • Excellent interpersonal skills, oral and written communication skills
  • Intellectually curious with a strong desire to understand a constantly improve your work and business processes
  • Able to work cross functionally across remote teams
  • Flexible and agile in ambiguous situations; open to changes in role and scope as the business grows EEO Employer Work from Home

Keywords: One Call, San Antonio , Provider Relations Specialist, Other , San Antonio, Texas

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