Provider Relations Rep (Lincoln/Omaha availability)

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Administrative/Clerical
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2020-R0276561 Requisition #
Thanks for your interest in the Provider Relations Rep (Lincoln/Omaha availability) position. Unfortunately this position has been closed but you can search our 1 open jobs by clicking here.

Job Summary

The Provider Relations Rep contributes to the mission and vision of CHI Health Partners by working through the CHP Healthcare Network as a liaison between physicians and their office staff, hospitals and managed care payors. Responsible to assist physician and hospital providers with managed care contract questions and concerns.  Works with payors concerning physician and healthcare facility operational issues and services.  Provider Relations Reps are also responsible to educate hospitals and physician offices about managed care plans and to assist providers to perform optimally in these plans.  A Provider Relations Rep will facilitate meetings with current CHP network providers, assist in recruiting new providers and monitoring the CHP provider network.

 

Essential Key Job Responsibilities

  • Provides ongoing services and educational programs to physicians, hospitals and office staff including regular meetings with office staff to inform them about current or new managed care contracts, to review utilization and financial reports and assist with resolving payor problems.
  • Visits physician offices to facilitate awareness of CHP Health Partners services and requirements.
  • Analyzes and interprets managed care provider utilization reports to determine provider financial performance and provide educational assistance where applicable for improvement strategies.
  • Communicates with managed care payors to meet their needs for physician credentialing and participating physician issues.
  • Creates and evaluates fee schedule comparison reports for physician offices.
  • Prepares supporting documentation and attends CHP committee meetings to include:   Clinically Integrated Network (CIN) Council, and Credentialing Committees.
  • Researches and prepare articles for publication in CHP Health Partners Physician Newsletter.
  • Plans, organizes and facilitates meetings and special events for CHP Health Partners network physicians.
  • Assists credentialing coordinator to gather, process, and review information for physician credentialing files.
  • Recruits primary care physicians and specialist physicians to join CHP Health Partners as needed.
  • Completes projects and resolve issues in a timely manner, ensuring they are handled appropriately and answered to the satisfaction of providers and clients.
 

Minimum Qualifications

Bachelor’s Degree or a minimum of 3 years related experience


 Bachelor’s Degree and three to five years of experience working with physicians, office staff, healthcare facilities or physician office management experience.  Knowledge about practices of managed care is highly desirable.  Relevant experience with an insurance company will be considered. 


Knowledge of provider and payor roles in a healthcare environment and practices of managed care are essential.  Strong interpersonal skills both verbal and written. Must be self-directed, team oriented and have the ability to communicate with all levels of staff and customers.  The Provider Relations Rep must maintain strict confidentiality, communicate effectively (both verbal and written) with physicians, office staff, and personnel of managed care plans, as well as develop working relationships with the above.  Personal computer skills in Outlook, Excel, Word and other Microsoft applications is required.


About Us


We are excited to share that CHI was named as one of America’s Best Employers 2019, by Forbes. Click here to learn more.


Chances are, you’re here because you’re looking for a career offering greater opportunity, challenge and fulfillment. We’re confident you’ll find all three at CHI. As one of the nation’s largest nonprofit health systems, we offer a wealth of careers across more than 101 hospitals in 18 states. Our faith-based health system welcomes you to share in our mission of building healthier communities, whether as a surgeon in the operating room or an administrator in a conference room. When you work in a supportive environment with like-minded professionals, wonderful things happen. Learn More

Equal Opportunity Employment


Consistent with our Core Values, Catholic Health Initiatives employers are EEO/AA/M/F/Vets/Disabled Employers. Qualified applications will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identification, protected veteran status, disability or any other legally protected characteristic

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