Provider Relations Manager in Rocky Hill, CT at Beacon Health Options

Date Posted: 7/9/2018

Job Snapshot

Job Description

ABOUT THE POSITION

Under the direction of the Director of Provider Relations, the Provider Relations Manager I ensures compliance with the terms of the customer contract, provides support in the areas of facilitating resolution of provider issues or concerns, monitoring the provider network, support ongoing Provider Relations project management activities when requested and develop training materials for provider related training and/or VO staff.

Position Responsibilities:

  • Supports the provider relations department by managing provider relationships through practitioner and facility orientation, provider inquiries, training, attendance at meetings and participation in resolution of issues and/or complaints as necessary.
  • Answer practitioners/facility questions regarding enrollment, authorization and Beacon/Medicaid policies and procedures. 
  • Participate in the maintenance of provider files. Obtain, process, manage and maintain both hard-copy and computer based provider information necessary for network development and maintenance activities.
  • Verify that provider information is current and updated in our database.  Respond to providers’ requests for enrollment and authorization information.
  • Research and Problem Resolution: Perform research and problem resolution on issues related to provider complaints, authorizations reported to have been processed incorrectly, provider communications or verification of information as requested.  Review and analyze provider information and status though database queries. 
  • Contributes to provider newsletters, the provider handbook, and identification of provider mailings, trainings, and other provider needs based on provider training evaluation results and/or general feedback.
  • Develops, delivers and maintains a comprehensive Training Program, for providers.  Maintains a master calendar and schedule of provider meetings/trainings to ensure education and outreach requirements are satisfied in accordance with contract.
  • Responsible for maintaining all website materials, updates and enhancements and working with Corporate office through completion.
  • Responsible for writing and designing course materials to produce products that are consistent with sound instructional design principles. Development of training materials may include research and collaboration with subject matter experts. The types of materials to be prepared include presentations, courses, training videos, tests, handouts, facilitator notes and documentation.
  • Deliver classroom training (to audiences of 2 to 200+) utilizing effective facilitation methods to enable the delivery of curriculum and to create a training environment conducive to learning.  Exceptional ability to train providers/staff at different learning levels, and apply appropriate methods for successful instruction.
  • Prepares reports as requested by management
  • Strong technical aptitude and a demonstrated ability to succeed in a fast-paced, constantly changing environment.
  • Ensure all provider distribution lists are maintained.
  • Performs miscellaneous job-related duties as assigned.

Position Requirements:

  • Education: Bachelor’s degree in human services or a related area is preferred.
  • Licenses: CPA or MBA Preferred
  • Relevant Work Experience: At least three years’ experience working in a customer service or provider relations/network operations role, preferably in a healthcare environment.   Extensive experience with detail oriented projects, strong computer skills and training experience preferred.

Knowledge, Skills & Abilities:

  • Excellent written and oral communication skills, flexibility, problem solving ability, creativity, teamwork skills, and prioritization skills required.
  • Strong project management skills are a necessity.
  • Exceptional computer skills, including Microsoft Office applications (with emphasis in Word, Power Point, Excel, Project and Publisher).
  • Must have a strong grasp on current technologies used in a corporate training environment and e-learning.
  • Strong organizational, communication, analytical, aggregate and interpret data, present data findings, problem solving, and staff management skills are required.
  • Strong customer service orientation.
  • Ability to travel to local and distant provider offices in assigned region by automobile, air, or other means.

To Apply:

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Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment.  EOE/AA/M/F/Veterans/Disabled

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