Provider Relations Representative
: Job Details :


Provider Relations Representative

VNS Health

Location: New York,NY, USA

Date: 2024-12-10T07:30:42Z

Job Description:

OverviewManages all aspects of provider relations within a specified geographic region. Regularly visits and maintains ongoing contact with existing/potential providers for relationship building, recruitment, credentialing, re-credentialing and assisting with provider issues and education. Works under general supervision.

Compensation Range:$30.71 - $38.41 Hourly

What We Provide

  • Referral bonus opportunities

  • Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays

  • Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability

  • Employer-matched retirement saving funds

  • Personal and financial wellness programs 

  • Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care  

  • Generous tuition reimbursement for qualifying degrees

  • Opportunities for professional growth and career advancement 

  • Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities  

  • Interdisciplinary network of colleagues through the VNS Health Social Services Community of Professionals.

What You Will Do

  • Manages all provider contracts in designated territory, including recruitment, credentialing, recredentialing and relationship maintenance through regular visits and ongoing contact with existing and potential providers.

  • Prepares materials for and orient providers to contract terms and operating requirements, Health Plan program and eligibility requirements, and service coordination.

  • Collaborates with the Network Development and Contracting and Service Operations departments to administer demographic changes and renewals to provider contracts.

  • Monitors contract performance of network providers and serves as a liaison between the Health Plan and the Provider to ensure the flow of information regarding resolution of member service issues.

  • Coordinates provider site visits, as needed.

  • Coordinates and attends meetings to serve as a resource and addresses provider issues.

  • Updates and maintains provider manuals with current Health Plan policies and procedures.

  • Updates and proofs provider directories.

  • Assists providers in triaging billing and claims disputes.

  • Participates and collaborates with Compliance on Department of Health and internal audits.

  • Participates in special projects and performs other duties as assigned.

Qualifications

Licenses and Certifications:

  • Driver's license, required

Education:

  • Bachelor's Degree or equivalent related work experience, preferably in health care setting, required

Work Experience:

  • Minimum three years health care experience, required

  • Knowledge of government programs, including Medicare and Medicaid, preferred

  • Prior experience in Provider Relations, preferred

  • Reliable transportation to work sites, required

CAREERS AT VNS Health

The future of care begins with you. Together, we will revolutionize health care in the home and community. When you join VNS Health, you become a part of something bigger. For generations, we've been a recognized leader and innovator in patient-centered and community-focused health care. At VNS Health, you'll have the opportunity to meaningfully impact lives. Including yours. Discover your next role at VNS Health.

Apply Now!

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