Provider Relations Representative, Sr. jobs in Huntington Beach, CA

Provider Relations Representative, Sr. supports, develops and maintains service relationships with all participants (physicians, providers and administrators) of a provider network. Responds to electronic and direct inquiries from clients about policies, rates, changes, referrals, eligibility, credentialing, etc. May provide guidance or expertise to less experienced representatives. Being a Provider Relations Representative, Sr. typically requires a bachelor's degree. Typically reports to a supervisor or manager. The Provider Relations Representative, Sr. gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Provider Relations Representative, Sr. typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)

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Provider Relations Specialist
  • CareConnectMD, Inc
  • Costa Mesa, CA FULL_TIME
  • Responsible for engaging partner providers and facilities on a variety of patient Experience, Quality, Risk Adjustment activities. These activities include liaising with partner provider and facilities to build and maintain relationships to drive engagement to improve Patient Experience, Quality and Risk measures. In addition, the Provider Relations Specialist will connect partners providers and facilities to CareConnectMD resources, tools, and reports to enhance day to day operations and to impact key metrics.

    Key Duties and Responsibilities
    • Regularly engage with partners providers to participate in JOC meetings, support coordinate visits, and educate providers to utilize our 24/7 service for ER diversion.
    • Tailor engagement and best practices shared with each partner provider to enhance day to day operations to impact key metrics.
    • Provide providers and facilities the actionable metrics and tools to drive improvement and connect providers to appropriate departments when needed.
    • Provide access to CareConnectMD resources like education by certified coders, and office staff training.
    • Support and leverage CCMD’s offered services e.g., case management resources, business development, and clinical services to reach our desired outcomes.
    • Function as point-of-contact for all partner providers and facilities.
    • Communicate effectively with providers to confirm existing patient experience initiatives and areas of needed improvement.
    • Interact with providers, office managers, staff in a positive, collaborative, and professional manner.
    • Work effectively with operational/clinical/BD team to issues that may be impacting performance.
    • Adhere to productivity set by the department leadership.
    • Continually search for opportunities to streamline and improve workflows and operations so we can more effectively ensure the quality of our provider and facility experience.
    • Other duties as assigned.
    Education and Experience
    • Bachelor's Degree and 3 years of experience working in health care provider services required.
    • Strong presentation, relationship building, problem-solving, critical thinking, and decision-making skills required.
    • Strong oral and written communication skills required.
    • Demonstrate ability to manage multiple projects and meet deadlines.
    • Ability to work independently with minimal supervision required.
    • Excellent organizational and time management skills required.
    • Proficiency in MS Word, Excel, PowerPoint, and Outlook required.
    • Travel will be needed, must have valid CA driver's license, car insurance, and reliable vehicle.
    Essential Skills and Abilities
    • Thrives in an unstructured, start-up environment.
    • Self-starter that can work independently and collaboratively, prioritize tasks and has initiative and excitement to take on unfamiliar tasks.
    • Advanced knowledge of word processing, graphic presentation and computer software related to specific tasks
    • Demonstrated excellent computer and word processing skills with special emphasis on calendaring, presentation, and spreadsheet capabilities
    • Working knowledge of company policies, procedures, and operations
    • Excellent composition, grammar, and business language skills
    • Excellent communication and interpersonal skills with the ability to effectively communicate with all levels of management, patients, and family members.
    • Creative, flexible, well organized, resourceful, and detail-oriented
    • Excellent judgment in handling confidential and sensitive information
    • Ability to work independently, set priorities and handle multiple tasks with a high level of efficiency
    • Establishing and maintaining cooperative working relationships with others
    • Ability to work across locations and time zones
    Core Competencies
    • Instills trust
    • Customer focus
    • Manages ambiguity
    • Collaborates
    • Drives results

    To ensure the health and safety of our workforce while doing our part to protect those around us, CareConnectMD is requiring proof of full COVID vaccination for employees as a condition of employment, subject to legally recognized accommodations.
  • 22 Days Ago

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Sr. Director, Investor Relations
  • VIANT
  • Irvine, CA FULL_TIME
  • For over 21 years, Viant has been a leader in digital advertising, transforming the way marketers connect their brands with consumers. Our industry-leading software, Adelphic, is used every day by the...
  • 24 Days Ago

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Sr. Contractor Relations Manager, DSP Relations
  • Amazon
  • Irvine, CA FULL_TIME
  • DESCRIPTIONWe are looking for a dynamic, organized self-starter to join our NA DSP team supporting our NA Delivery Stations for contractor relations issues, including requests for disability and relig...
  • 4 Days Ago

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Provider Relations (Customer Service Phone Support)
  • Elite
  • Irvine, CA FULL_TIME
  • Provider Relations - (Customer Service Phone Support) Location: Irvine, CA 92606 Type: Temp to possible Hire; no guarantees of duration of temp assignment or if assignment will convert to full time em...
  • 1 Month Ago

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Customer Relations Representative
  • Experiential Inc.
  • Costa Mesa, CA FULL_TIME
  • We are now accepting applications for a Customer Relations Representative for our newest client. Be a part of an exciting, fun work environment while helping to develop the local market. The ideal can...
  • Just Posted

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Customer Relations Representative
  • Experiential Inc.
  • Huntington, CA FULL_TIME
  • We are now accepting applications for a Customer Relations Representative for our newest client. Be a part of an exciting, fun work environment while helping to develop the local market. The ideal can...
  • 7 Days Ago

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0 Provider Relations Representative, Sr. jobs found in Huntington Beach, CA area

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Customer Relations Representative
  • Experiential Inc.
  • Huntington Beach, CA
  • We are now accepting applications for a Customer Relations Representative for our newest client. Be a part of an excitin...
  • 3/28/2024 12:00:00 AM

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Customer Relations Representative
  • Priam, Inc.
  • Torrance, CA
  • We are a business and marketing firm that was founded almost a decade ago. We are looking to hire a Customer Relations R...
  • 3/28/2024 12:00:00 AM

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ASM/Service Advisor
  • Toyota of Huntington Beach
  • Huntington Beach, CA
  • Job Title: ASM/Service Advisor Department: Service Reports to: Service Manager FLSA Status: Exempt Position Summary: Ess...
  • 3/28/2024 12:00:00 AM

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Customer Service Specialist
  • Elysium Ventures
  • Huntington Beach, CA
  • Customer Service Specialist We are looking for a full-time employee who will provide customer service and customer suppo...
  • 3/28/2024 12:00:00 AM

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Customer Relations Representative
  • Century Communities
  • Newport Beach, CA
  • **Description** *Position at Century Communities* **About Century Communities** As a top 10 U.S. homebuilderand the fast...
  • 3/27/2024 12:00:00 AM

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Customer Relations Representative
  • MaxLite
  • Anaheim, CA
  • Customer Relations Representative Customer Relations Job Type Full-time Description **Customer Relations Representative*...
  • 3/27/2024 12:00:00 AM

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Provider Relations Representative
  • Molina Healthcare
  • Long Beach, CA
  • Job Description ***Remote and must live in the Riverside or San Bernardino areas*** Job Description Job Summary Molina H...
  • 3/25/2024 12:00:00 AM

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Provider Relations Representative
  • MBI Health Services
  • Los Angeles, CA
  • Job Description Job Description Position Title: Provider Relations Representative Job Type: Full-Time / Hybrid Departmen...
  • 3/25/2024 12:00:00 AM

Huntington Beach is a seaside city in Orange County in Southern California. The city is named after American businessman Henry E. Huntington. The population was 189,992 during the 2010 census, making it the most populous beach city in Orange County and the seventh most populous city in the Los Angeles-Long Beach-Anaheim, CA Metropolitan Statistical Area.[citation needed] Its estimated 2014 population was 200,809. It is bordered by Bolsa Chica Basin State Marine Conservation Area on the west, the Pacific Ocean on the southwest, by Seal Beach on the northwest, by Westminster on the north, by Fou...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Relations Representative, Sr. jobs
$79,562 to $98,668
Huntington Beach, California area prices
were up 3.0% from a year ago

Provider Relations Representative, Sr. in Kingsport, TN
A job as a Provider Relations Representative falls under the broader career category of Business Operations Specialists, All Other.
February 18, 2020
Provider Relations Representative, Sr. in Sioux City, IA
The PR Rep serves as a liaison between contracted payers, providers and ancillary providers to promote superior customer service and seamless programs.
February 16, 2020
Provides telephonic provider education to new providers.
February 14, 2020
Provider Relations Representative, Sr. in Buffalo, NY
This position provides on-going communication, in-service, orientation, and direction to these contracted provider offices.
February 03, 2020