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November 19, 2019  
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Provider Relations Specialist II

Position Description

Provider Relations Specialist II


009P1


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


USA-Tennessee-Nashville


Commercial Solutions


Full-time



Additional Information

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


Apply For This Job: Provider Relations Specialist II


 

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