Talent.com
Provider Relations Representative
Provider Relations RepresentativeAmerican Health Partners • Shreveport, LA null, US
No longer accepting applications
Provider Relations Representative

Provider Relations Representative

American Health Partners • Shreveport, LA null, US
30+ days ago
Job type
  • Full-time
Job description

American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors who reside in long-term care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage medical risk by improving patient care to reduce emergency room visits and avoidable hospitalizations. This division currently operates in Tennessee, Georgia, Missouri, Kansas, Oklahoma, Utah, Texas, and Mississippi, Louisiana, Iowa, and Idaho with planned expansion into other states in 2024. For more information, visit.

If you would like to be part of a collaborative, supportive and caring team, we look forward to receiving your application!

Benefits and Perks include :

  • Affordable Medical / Dental / Vision insurance options
  • Generous paid time-off program and paid holidays for full time staff
  • TeleDoc 24 / 7 / 365 access to doctors
  • Optional short- and long-term disability plans
  • Employee Assistance Plan (EAP)
  • 401K retirement accounts
  • Employee Referral Bonus Program

ESSENTIAL FUNCTIONS : To perform this job, an individual must perform each essential function satisfactorily with or without a reasonable accommodation

  • Contracting providers and essential vendors in current service areas to maintain CMS adequacy and providing necessary services in the care of the Plan members
  • Insuring providers and essential vendors in current service areas meet the credentialing requirements for their appropriate service lines
  • Educating providers on the Health Plan(s) functions and roles in caring for its membership
  • Ongoing educational updates as prescribed by CMS and the Health Plan(s) policies
  • To conduct the education presentations of the Health Plan(s) providers to insure their understanding and commitment with the Health Plan(s)
  • Monitor, maintain and support provider relationships to insure network coverage in all areas
  • To work with and be involved in implementation as needed
  • Establish a positive work environment that encourages participation in process improvement and commitment to department / company success
  • Complete corporate assignments as assigned
  • Required Skills :

  • Must be fluent in all current provider payment methodologies including per diems, DRGs, and APCs
  • Must have knowledge and familiarity with all levels of medical services and ability to rapidly develop working relationships
  • Must be able to accept instructions and work independently in the completions of goals and assignments
  • Must have strong negotiation, organization, presentation and time management skills
  • Must be able to effectively communicate with all levels of medical staff to explain Health Plan(s) program, benefits and goals
  • Must be able to work effectively in a team environment
  • Excellent computer skills, including Microsoft Office Suite
  • Must be self-motivated, dependable, team and goal-oriented
  • Required Work Experience :

  • Experience in the health care field required
  • Prior experience in network development / network services is preferred
  • Prior experience with acute and post-acute facilities is beneficial
  • Prior experience with Medicare Advantage plans is helpful
  • Licensing / Certification / Education Requirements :

  • Bachelor’s degree
  • Other Requirements :

  • Must be available to work 8 a.m. until 5 p.m. local time
  • Position requires travel to network provider locations.
  • Teleworking is an option if criteria are met
  • EQUAL OPPORTUNITY EMPLOYER

    Our Organization does not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. The Organization will also make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made.

    This employer participates in E-Verify.

    Create a job alert for this search

    Provider Representative • Shreveport, LA null, US

    Related jobs
    Pharmaceutical Sales Representative

    Pharmaceutical Sales Representative

    Syneos Health / inVentiv Health Commercial LLC • Shreveport, LA, United States
    Full-time
    Join Syneos Health in partnership with a large Biopharmaceutical company as a Pharmaceutical Sales Representative (PSR).Become a part of a fast-paced and challenging environment where our compassio...Show more
    Last updated: 17 days ago • Promoted
    Travel Physical Therapist (PT) in Shreveport, LA

    Travel Physical Therapist (PT) in Shreveport, LA

    AlliedTravelCareers • Shreveport, LA, US
    Full-time +1
    AlliedTravelCareers is working with Delta Healthcare Providers to find a qualified Physical Therapist (PT) in Shreveport, Louisiana, 71101!. Compensation : $1,810 - $2,122 estimated weekly pay .Star...Show more
    Last updated: 30+ days ago • Promoted
    Residential Sales Representative

    Residential Sales Representative

    ADT Careers • Shreveport, LA, United States
    Full-time
    ADT has been in the business of helping save lives since 1874.As the #1 smart home security provider in the U.Our continuous innovation, advanced technology and strategic partnerships deliver produ...Show more
    Last updated: 30+ days ago • Promoted
    Sales Representative, Life Insurance

    Sales Representative, Life Insurance

    Kemper • Shreveport, LA, US
    Full-time
    Kemper is one of the nation's leading specialized insurers.Our success is a direct reflection of the talented and diverse people who make a positive difference in the lives of our customers every d...Show more
    Last updated: 30+ days ago • Promoted
    Medical Equipment Customer Service Representative (TEMP)

    Medical Equipment Customer Service Representative (TEMP)

    Rotech Healthcare Inc. • Bossier City, LA, United States
    Full-time
    Join a Leader in Home Healthcare.As a national leader in ventilators, oxygen therapy, sleep apnea treatment, wound care, diabetic solutions, and other home medical equipment, we empower patients to...Show more
    Last updated: 27 days ago • Promoted
    Travel Physical Therapist (PT) - $1,820 to $3,000 per week in Houston, LA

    Travel Physical Therapist (PT) - $1,820 to $3,000 per week in Houston, LA

    AlliedTravelCareers • Shreveport, Louisiana, US
    Full-time
    AlliedTravelCareers is working with CompHealth to find a qualified Physical Therapist (PT) in Houston, Louisiana!.Interested in this assignment? Or maybe you still have not found what you are looki...Show more
    Last updated: 30+ days ago • Promoted
    Sales Representative, Inbound Remote

    Sales Representative, Inbound Remote

    Liberty Mutual Insurance Group • Shreveport, LA, US
    Remote
    Full-time
    Now Hiring : Future Remote Inside Sales Representatives!.Are you ready to launch a rewarding career in insurance sales? We're inviting motivated, people-focused individuals to apply in advance for o...Show more
    Last updated: 24 days ago • Promoted
    Cash Management Services Teller

    Cash Management Services Teller

    Loomis • Shreveport, LA, United States
    Full-time
    With a network of nearly 200 branches, Loomis armored transportation, cash management centers, and cash inventory vaults keep cash flowing throughout financial institutions and retail businesses ac...Show more
    Last updated: 15 days ago • Promoted
    Field Sales Representative

    Field Sales Representative

    Automation-X Corporation • Shreveport, Louisiana, USA
    Full-time
    The Field Sales Representative is accountable for direct sales and customer service support to Automation-Xs customers with a focus on new customer growth and increasing regional market share.This ...Show more
    Last updated: 17 days ago • Promoted
    Treasury Management Relationship Support Specialist

    Treasury Management Relationship Support Specialist

    Regions Bank • Shreveport, LA, United States
    Full-time
    Thank you for your interest in a career at Regions.At Regions, we believe associates deserve more than just a job.We believe in offering performance-driven individuals a place where they can build ...Show more
    Last updated: 8 days ago • Promoted
    Sales Representative

    Sales Representative

    Globe Life Family Heritage Division • Shreveport, LA, US
    Full-time
    Globe Life Family Heritage Division Sales Professional.Looking to make an impact in a thriving work environment? If you’re a highly motivated self-starter, then come join Globe Life Family Heritage...Show more
    Last updated: 13 days ago • Promoted
    Sales Representative, Life Insurance

    Sales Representative, Life Insurance

    Louisiana Staffing • Shreveport, LA, US
    Full-time
    Location : Shreveport, Louisiana.Kemper is one of the nation's leading specialized insurers.Our success is a direct reflection of the talented and diverse people who make a positive difference in th...Show more
    Last updated: 30+ days ago • Promoted
    Bilingual Retail Sales Representative

    Bilingual Retail Sales Representative

    SPECTRUM • Taylortown, Louisiana, United States
    Part-time
    This role requires the ability to work lawfully in the U.Earn $18 / hour base pay, with the potential to earn $23.Plus, enjoy perks like free and discounted internet, TV, and mobile, all while paving...Show more
    Last updated: 3 days ago • Promoted
    Remote Sales Representative

    Remote Sales Representative

    The Blue Haven Life • Bossier, Louisiana, USA
    Remote
    Full-time
    You will support clients who have expressed interest in insurance solutions by conducting virtual meetings identifying needs and recommending plans. This role is fully remote and commission-only bui...Show more
    Last updated: 6 days ago • Promoted
    Remote Sales Representative

    Remote Sales Representative

    Ohana Outreach Financial • Shreveport, LA, us
    Remote
    Full-time
    Quick Apply
    This role provides a flexible remote work path for individuals seeking long-term earning potential.You’ll guide families through their protection choices during virtual meetings.You will respond to...Show more
    Last updated: 8 days ago
    Licensed Talk Therapist - Fee For Service

    Licensed Talk Therapist - Fee For Service

    Thriveworks • Shreveport, LA, United States
    Full-time
    Thriveworks is currently seeking Licensed Clinicians to provide a mix of telehealth and face-to-face sessions in Shreveport, LA. This role is eligible for a $7,500 ramp stipend for clinicians offeri...Show more
    Last updated: 8 days ago • Promoted
    Relationship Manager

    Relationship Manager

    Resource Energy Equipment • Shreveport, LA, USA
    Full-time
    Quick Apply
    Customer Focus : Knowledge of the values and practices that align customer needs and satisfaction as primary considerations in all business decisions and ability to leverage that information in crea...Show more
    Last updated: 30+ days ago
    Service Representative

    Service Representative

    Abacus Service Corporation • Bossier City, LA, United States
    Full-time
    Lincare is the nation's leading provider of oxygen, durable medical equipment, and clinical respiratory services, currently seeking a Delivery Driver to join a growing team.Drivers will be respons...Show more
    Last updated: 1 day ago • Promoted