ROLE AND RESPONSIBILITIES

The Provider Relations Representative is responsible for communicating with all Providers and acting as the liaison between Careways and the Provider. Responsibility for growth of relationships with Physicians, Clinics, Networks and Hospitals.  Provide training on the role and responsibility Careways plays within the primary care relationship. Responsibility for Provider inquiries and focusing on those providers that have a high impact on our Member population.  This includes: facilitating provider communication, program implementation and conflict resolution functions. The PR Representative serves to promote superior customer service.

We are looking for an individual to join our Provider Relations team who is motivated to provide best in class service for our client’s and innovative solutions as we continue to grow and develop internal processes to meet the needs and expectations of our customers.  We strongly believe in the value of people and that this value will directly impact our relationship with the Provider, our members and customers. We are a collaborative team and are looking for someone to make valuable contributions to our team’s vision.

CORE FUNCTIONS

• Provider Group management – overall management and fostering an environment of strong positive relationships and process innovation
• Proactively identify Provider’s needs, resolving and communicating concerns or complaints regarding programs to maintain Provider engagement and satisfaction
• Strategic planning to drive engagement numbers
• Responsible for coordinating and facilitating all meetings with Provider’s Office Managers and Care Team trainings
• Coordinate with the VP of Operations to bring innovative processes, reporting, and communication integration for all Provider Groups
• Identify opportunities for improved processes and Provider Group participation in established programs
• Assure that all Provider Group’s trainings, reporting, compliance and site visits are completed within established time frames
• Manage ongoing processes, new integration processes, Provider Relations strategic planning, utilization reporting
• Continuous mindset toward efficiency and process improvement – how to apply technology and processes to improve delivery and efficiency from both the Provider Group and internal perspective
• Oversee the maintenance of the Provider Relations database that includes all participating physicians and ancillary providers for the assigned territory
• Complete all provider orientations and site visits within designated timeframes
• Represent the organization well; support its mission, goals and objectives; participate as a ‘team player”, constantly supporting other managers; set an example of high personal and professional conduct for employees and others
• Create reports, projects, and other duties, as appropriate
• Monitor and trend provider issues documented through workflow, calls, emails, and other avenues

QUALIFICATIONS AND EDUCATION REQUIREMENTS

• Associate’s Degree or equivalent work experience. (Bachelor’s degree a plus)
• 1-2 years’ experience in a physician’s office or 3-5 years related experience in health care environment serving in a provider relations role
• Experience in public speaking and/or group presentations
• Strong client focus (provide examples of success)
• Value people; demonstrate professional respect and innovative mindset
• Confident in working with heath care professionals
• Passionate about your work and move forward with purpose; demonstrate clear value and support of your Provider Groups and internal teams
• Exercise judgement in order to problem solve when the answer is not readily apparent
• Approach problem solving that involves systems thinking and with a clear value of people – understanding how the whole process works and how people are impacted by your decisions from the Provider Group perspective and internally
• Strong communication skills – understanding the need for being inclusive for effective results; communicate effectively with both day to day operational resources and executive management
• Understand sense of urgency, fast-paced and multi-tasking environment; strong organizational skills
• Solutions oriented mindset, willing to bring Provider Groups results regardless of roles or titles
• Requires daily local travel to provider offices. (mileage reimbursement provided)
• Willingness and ability to attend after hour business meetings as needed
• Must maintain valid driver’s license and use personal vehicle for travel

Experience with basic Microsoft Office Applications

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