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General Information

Req ID
R015947
State
New York

Description and Requirements

The Provider Relations Representative represents and advances Healthfirst interests in the provider market as the preferred and ultimately preeminent health plan through superior customer service and execution of the provider engagement strategy.
Duties/Responsibilities: Serve as plan liaison for physicians/physician groups in the entire network. They will be a point of contact for all Healthfirst related issues for the providers. They will hold the responsibility for the resolution of all issues, including those identified by the provider, and those identified internally that have an impact on the physician. The Provider Relations Representative will coordinate with all Healthfirst staff to assist as appropriate, including creating project plans, issue logs, conference calls, etc. Schedule frequent and regular face-to-face contact with the practice locations to educate providers on Healthfirst products, initiatives, identify any issues, and ensure plan visibility. Conduct provider education activities on the provider portal and current Healthfirst policies. There is and additional focus on access and availability education. The Provider Relations Representative will include experts in the field of education as needed from in-house staff when appropriate. Work autonomously under light supervision to balance multiple tasks independently with a fast-paced proactive vs. reactive approach to changing priorities while meeting departmental objectives. Attention to managing many details and remaining focused in an environment with distractions. Contribute creative solutions and ownership of daily assignments for seamless communication and systematic completion of routine and special projects. Follow protocols and use common sense to escalate situations to management appropriately. Follow strict Customer Service protocols while being mission driven, proactive and using critical thinking Create effective business correspondence Additional duties as assigned. Minimum Qualifications: High School Diploma or GED Experience related to network management, provider relations, sales, customer services, or health industry. Expert is MS Office suite of applications (create excel formulas and functions Ability to work independently in a demanding fast-paced environment Ability to prioritize and manage projects while multi-tasking Strong problem-solving skills coupled with ability to facilitate resolution to issues An entrepreneurial spirit that looks to the best interests of the plan and its providers by bridging and creating common interests to develop meaningful provider partnerships and experiences for our members. Excellent oral and written communication skills Preferred Qualifications: Bachelor's degree Medicare and/or Medicaid managed care experience Customer service experience in retail, hospitality, and/or healthcare services Professional Writing skills (Letter writing, Memo and Email) Excellent oral and written communication skills
Hiring Range*: Greater New York City Area (NY, NJ, CT residents): $65,600 - $94,775 All Other Locations (within approved locations): $58,300 - $86,700 As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision. In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live. *The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.