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November 19, 2019  
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Provider Relations Specialist II

Position Description

Provider Relations Specialist II


Position Purpose: Serve as a liaison between providers, the health plan and Corporate to investigate and resolve provider claims

- Conduct on-site provider orientations, including writing and updating orientation materials and assisting providers acclimated to plan website

- Monitor financial performance of contracts

- Investigate and document provider changes and correspondence

- Coordinate with credentialing to ensure all appropriate documentation is received

- Serve as a lead for key special projects

- Recommend changes in pricing subsystems

- Coordinate printing of provider directories with corporate and plan level entities

- Investigate and respond to complex provider related issues and initiate change of provider related database information

- Serve as a subject matter expert for provider relations activities and as a mentor for Provider Relations Specialist I staff

- Ability to travel

Education/Experience: High school diploma or equivalent. Bachelor's degree in healthcare related field preferred. 5+ years of sales, provider relations, or contracting experience. Claims processing and/or managed care experience preferred. Driver's License may be required by some plans. Specific language skills may be required by some plans.

License/Certification: Valid driver's license.

Business Development & Sales


Commercial Solutions


Additional Information

Employment Type: Full-Time    
Position Location: Nashville, Tennessee

Apply For This Job: Provider Relations Specialist II


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