The Provider Relations Representative is responsible for field and office activities in educating, supporting, and contracting with the health plan’s provider network. The Provider Relations Rep will work closely with contracted providers and assist in contracting with new primary care and specialist care providers. In addition, the Provider Relations Representative has the following responsibilities:
Must be able to have effective interaction with all Providers
Provide support and ongoing education to contracted providers and their office staff regarding health plan policies, procedures, and contractual obligations to ensure compliance with state and federal regulations
Develop collaborative relationships with Physicians, Clinics, Ancillary Providers, Hospitals and other providers
Assist with outreach for new provider contracts, amendments and other types of agreements in a timely manner
Collects signed contracts, amendments and other documentation
Coordinates the distribution of contracts and amendments within specific time limits
Able to create and distribute provider contract reports as needed for the organization in a timely manner
Works closely with other departments on new business projects
Ability to handle provider concerns in empathetic and caring manner
Communicate verbally and in writing with providers
Performs other position appropriate duties as required in a competent, professional and courteous manner
The ideal candidate will have at least three (3) years experience in health plan, physician or other type of provider organization. The individual must have an understanding of health plan/managed care operations (i.e, patient referrals, claims process, eligibility information, contracting) the ability to work alone with minimal supervision as well as communicate effectively with external and internal customers.
Baylor Scott & White Health (BSWH) is the largest not-for-profit health care system in Texas and one of the largest in the United States. With a commitment to and a track record of innovation, collaboration, integrity and compassion for the patient, BSWH stands to be one of the nation’s exemplary health care organizations. Our mission is to serve all people by providing personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. Joining our team is not just accepting a job, it’s accepting a calling!