Provider Relations Representative

Location:  Columbia, SC – And Surrounding Counties

Company:  Community Health Solutions

Summary

The Network Provider Relations Representative works in the field and acts as a facilitator of information between health plans and the network providers.

Essential Duties and Responsibilities:

  • Conducts marketing, recruitment and contracting of provider for participation in government programs
  • Collects credentialing information and facilitates the contract execution process for provider participation in government programs
  • Educates physicians and staff as to their contractual responsibilities for program participation
  • Conducts quarterly on-site meetings with participating provider practices
  • Interacts as needed with providers with regard to new/updated information on program operations, Quality Assurance programs, administrative procedures, and other policies for all contracted physicians, ancillaries and other identified providers
  • Responds to inquiries, questions or concerns about the program in a timely manner
  • Resolves complaints and operational issues in collaboration with the Provider Services Manager
  • Communicates effectively with all program participants
  • Assists with coordination of administrator and physician meetings
  • Participates in outreach programs including conferences, fairs and other program related events

Other Responsibilities:

  • Adheres to the policies and procedures of Community Health Solutions of America, Inc.
  • Maintains strict confidentiality of client, company and personnel information
  • Demonstrates a strong commitment to the mission and values of the organization
  • Adheres to company attendance standards
  • Performs other duties as assigned

Supervisory Responsibilities:   None

Competencies:

  • Strong organizational and interpersonal skills
  • Excellent written and verbal communication skills
  • Detail oriented
  • Ability to multi-task and work independently

Qualifications:

  • A minimum of one year of previous Provider Relations  experience is preferred.
  • Knowledge of Medicaid regulations and policies and procedures is desirable.

Education and/or Experience:

A high school degree is required. Some college coursework is preferred.

Certificates, Licenses, Registrations:  None

Computer Skills:

Proficiency using a Windows XP computer platform

Environmental Factors/Physical Demands:

Extensive travel is required in this position. While performing the duties of this job, the employee is regularly required to drive. Must have the ability to maintain active customer communication; access, input and retrieve information for the computer system, enter alpha-numeric data into a computerized system often while listening on the telephone. May be subject to repetitive motion such as typing, data entry and vision to monitor. May be subject to sitting for long periods of time, bending, reaching, kneeling, stooping and lifting up to thirty (30) pounds.

To apply, please forward resume to careers@chsamerica.com

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