Provider Relations Representative

MMF-Medical Foundation
Full Time
Day Job
Job Listing: 
Administrative, Clerical
A Provider Relations Representative facilitates the organizational goals with physicians as well as staff throughout MemorialCare Medical Foundation.  In collaboration with internal departments they ensure timely responses to physicians and their staff.
Essential Functions and Responsibilities of the Job
  • Communicate effectively in a timely, proactive and professional manner.
  • Open communication with leadership regarding provider issues and facilitation of resolution.
  • Ongoing learning and increased knowledge of systems and initiatives.
  • Collaborate with multiple teams and vendors to ensure timely response to physician concerns.
  • Maintain a high level of productivity and self-direction as position is largely field based and must be available at all times.
  • Be at work and be on time
  • Follow company policies, procedures and directives
  • Interact in a positive and constructive manner
  • Prioritize and multitask
Essential Job Outcomes
  • Provide support to Physicians and their staff via in-person assistance, phone calls, emails
  • Leads detailed On-Boarding to new physicians and staff
  • First line of contact for all interdepartmental requests related to provider issues
  • Acts as liason to providers, escalating concerns to leadership as appropriate
  • Participates with activities and functions as they relate to physician growth as well as identifying network trends and gaps by working with internal departments and analyzing reports
  • Leads as primary contact for portal implementation and responsible for increasing portal enrollment
  • Collaborates with Contracting Department related to network management and ACO initiatives
  • Coordinates with customer service department to research and resolve provider issues
  • Reports any dissatisfaction among providers and resolves within limits of authority, reporting issue and resolution to the Provider Relations management team or supervisor
  • �Other duties as assigned�
  • Minimum of two years� experience in health care, Provider Relations position required.
  • Epic or equivalent Managed Care electronic medical record system and provider portal applications knowledge preferred.
  • Experience with various healthcare industry regulatory agencies and requirements, including but not limited to CMS, NCQA, DMHC, ICE, DHCS, preferred.
  • Proficiency in Microsoft Office applications including Word, Power Point, Excel, and Outlook is a must.
  • Bachelor�s degree required. 
  • List the education licensures or certifications preferred or required to do the job.
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