Provider Relations Representative jobs in Reno, NV

Job Summary: The Provider Relations Manager is responsible for the satisfaction of Prominence Health Plan participating providers through managing a staff of representatives that builds and maintains excellent relationships and facilitates growth, retention, and quality of care. Analyzes specific issues pertaining to providers, and oversees the management, problem resolution and education of the provider network on Prominences’ performance improvement programs, services, policies, and procedures. Facilitates the development and implementation of quality performance strategies to effectively communicate to Prominence Health Plan providers and other key audiences. Responsible for managing a team of provider relations representatives. Collaborates with senior leaders on how to enhance or rectify encumbrances to performance improvement.

Qualifications and Requirements:

• High School Graduate/Equivalent, Bachelor’s Degree, preferred
• 3-5 years of related experience
• 3-5 years supervisory experience
• Experience in managing provider relationships, provider office, or provider communication preferred
• Knowledge of provider reimbursement, Medicare reimbursement, coding and Hedis Measures and care gap reporting preferred.
• Knowledge of Medicare Advantage and ACA risk scores and ability to educate providers and key levers to further enable the health plan’s success
• Understanding of provider office dynamics and optimal approaches to communicating and educating providers and provider staff
• Understanding of provider reimbursements and coinciding challenges (FFS, CPT code reimbursement, etc.)
• Understanding of health plan departments and functional areas for problem resolution
• Experience in customer service/relations-like roles
• Ability to effectively communicate in English, both verbally and in writing.
• Strong interpersonal skills with ability to build strong relationships
• Proficient in Microsoft Office skills (Excel, Word, PowerPoint, Access, etc.)
• Project management orientation and strong organizational skills
• Self-starter, resourceful and able to execute projects in a fluid and fast paced environment
• Strong analytical skills and attention to detail
• High level of energy related to developing and initiating communication plans, training, and educating

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.