Remote Provider Relations Advocate

Position Title : Provider Relations Advocate

Work Location : Remote / Telecommute

Work Hours : 9 am 5 pm

Position Background : The Provider Relations Advocate plays a crucial role in recruiting and contracting network providers, as well as providing network support.

This position contributes to the overall success of the business by building and maintaining strong relationships with providers.

Team Description : The candidate will be joining a diverse team of professionals situated throughout the United States. The team collaborates and strives to empower and uplift each other to achieve their best work.

Responsibilities :

• Serve as a provider advocate for assigned state(s) or territory.
• Take responsibility for network build and monitoring, ensuring the network is robust and meets the needs of the organization.
• Engage in ongoing provider relations activities, including conducting virtual provider site visits, providing provider education, and addressing escalated provider claim / service issues.
• Collaborate with internal and external stakeholders to ensure effective communication and resolution of provider-related concerns.
• Proactively identify and address opportunities for network expansion and improvement.
• Maintain accurate documentation and records of provider interactions and activities.
• Stay up-to-date with industry trends, regulations, and best practices related to provider relations and managed care.

Ideal Candidate Background :

The ideal candidate should have a background in provider relations and / or provider network management within the healthcare industry.

They should possess a deep understanding of managed care and demonstrate experience in establishing and maintaining strong relationships with healthcare providers.

Skills / Attributes Required :

• 4+ years of healthcare / managed care experience, with a focus on provider relations and / or provider network management.
• Intermediate level of proficiency in claims processing and issue resolution.
• Strong communication and interpersonal skills, with the ability to effectively engage and collaborate with providers and internal stakeholders.
• Detail-oriented with excellent organizational and documentation skills.
• Ability to work independently, manage multiple priorities, and meet deadlines.

Skills / Attributes Preferred :

Proficiency with MS Word, Excel, PowerPoint, and relevant software systems.

Minimum Education Requirement :

High school diploma / GED or equivalent.