Provider Network Representative

This position develops and maintains relationships with primary care and specialty physicians and ancillary providers for all product lines within designated geographic area(s) to drive business results. This position is responsible for the appropriate representation of providers relating to contractual arrangements, compliance, regulatory, credentialing, claims, provider files and administrative policy and procedures.

• Bachelor’s Degree in health care administration, business or an equivalent combination of education and work experience in managed care or health care.
• Minimum of three years’ experience in health care; including a minimum of two years in provider/ payer contracting.
• Experience in developing contract types, fee arrangements and other contract terms and in developing and recommending potential solutions to contract issues.
• Proficiency in Microsoft Office software (Word, Access, Excel).
• Ability to travel efficiently and continuously to and within assigned geographic area, including possessing a reliable personal vehicle.
• Excellent organizational and project management skills.
• Demonstrate understanding and sensitivity to multi-cultural values, beliefs, and attitudes of both internal and external contacts.
• Demonstrate appropriate behaviors in accordance with the organization’s vision, mission, and values.

Position Description »