Provider Relations Representative II in Atlanta, GA at Beacon Health Options

Date Posted: 10/23/2019

Job Snapshot

Job Description

ABOUT THE POSITION

We are currently seeking a dynamic Provider Relations Representative II to join our team at our office in Atlanta, GA.  The Provider Relations Representative II is responsible for provider outreach and servicing activities for their assigned territory based out of an engagement center, with oversight by a Manager, Provider Relations. Additionally, this position will field all provider / customer complaints and grievances reported  both internally and externally This position works in collaboration with Beacon Health Options departments, the client and the Georgia Collaborative member agencies to coordinate and participate in the required provider, member and stakeholder training sessions as required by our contract. Incumbent is responsible for training providers in the use of various provider systems, policies and procedures, system setup and the development of policies and procedures related to system setup. Training activities will also include developing and maintaining accurate and current technical documentation in support of all training courses provided by the Provider Relations Department.  Support ongoing Provider Relations project management activities when requested. Assist with developing training materials for provider related training and/or Beacon Health Options’ staff to include Quality departmental staff to use in providing training to providers on technical capabilities required to interface with the Beacon Health Options management information system and clinical. Provider relationship management with providers will be conducted telephonically, in their offices as necessary, and through attendance at professional gatherings.

Position Responsibilities:

1.       Participates in provider related initiatives, including attendance at trade shows, forums and symposia. 

2.       Supports the provider relations department by managing provider relationships through practitioner and facility orientation and training, attendance at meetings, providing review and feedback of provider performance under contract terms, participation in resolution of issues and/or complaints as necessary.

3.       Works collaboratively with National Network Services, Network Operations and customer operations staff to share information and ensure accurate and timely response to provider.

4.       Contributes to provider newsletters, the provider handbook, and identification of provider mailings, training, and other provider needs based on provider training evaluation results and/or general feedback.

5.       Assists in responding to audit requests in coordination with other internal departments.

6.       Assist in the development of training materials for system enhancements and problem resolutions, and assist in testing of system changes for validity and functionality.

7.        Performs provider outreach to manage ongoing relationship, and is a critical interface link with national network services and network operation staff in the seamless delivery of services to providers including: provider feedback to providers regarding their performance under the terms of contract and/or customer requirements; identifying and addressing quality of care and service issues, in conjunction with other Beacon Health Options departments; responding to provider complaints and questions as they arise; formulating provider report requests and participating in any local and/or national committees/meetings.

8.       Attends and participates in all mandatory meetings, which may include, but not limited to identifying training needs, gather relevant information verify and training material requirements are met in order to establish successful training outcomes.

9.       Records all complaints and grievances reported to Georgia Collaborative. Will track to resolution, and submit findings via monthly reporting.  Will support Quality Department with provider appeals as needed

10.   10% overnight and local travel

Position Requirements:  Bachelor’s degree in Business Administration, Science, Communications, or in a human services related area or combination Associates degree and experience considered in lieu of Bachelor’s degree is required.            

Relevant Work Experience:  At least three years of training, communications, or marketing experience required.  A minimum of two years in provider relations and/or a combination of managed care, behavioral healthcare, practice management and claims experience required.

Knowledge, Skills & Abilities:

•         Microsoft Office experience

•         Excellent written and verbal communication skills

•         Analytical skills

TO APPLY

Click below on “Apply for this Position” to create a profile and apply for the position

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

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.

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#CB

Incumbent is responsible for training providers in the use of various provider systems, policies and procedures, system setup and the development of policies and procedures related to system setup. Training activities will also include developing and maintaining accurate and current technical documentation in support of all training courses provided by the Provider Relations Department.  Support ongoing Provider Relations project management activities when requested. Assist with developing training materials for provider related training and/or Beacon Health Options’ staff to include Quality departmental staff to use in providing training to providers on technical capabilities required to interface with the Beacon Health Options management information system and clinical. Provider relationship management with providers will be conducted telephonically, in their offices as necessary, and through attendance at professional gatherings.

Position Responsibilities:

1.       Participates in provider related initiatives, including attendance at trade shows, forums and symposia. 

2.       Supports the provider relations department by managing provider relationships through practitioner and facility orientation and training, attendance at meetings, providing review and feedback of provider performance under contract terms, participation in resolution of issues and/or complaints as necessary.

3.       Works collaboratively with National Network Services, Network Operations and customer operations staff to share information and ensure accurate and timely response to provider.

4.       Contributes to provider newsletters, the provider handbook, and identification of provider mailings, training, and other provider needs based on provider training evaluation results and/or general feedback.

5.       Assists in responding to audit requests in coordination with other internal departments.

6.       Assist in the development of training materials for system enhancements and problem resolutions, and assist in testing of system changes for validity and functionality.

7.        Performs provider outreach to manage ongoing relationship, and is a critical interface link with national network services and network operation staff in the seamless delivery of services to providers including: provider feedback to providers regarding their performance under the terms of contract and/or customer requirements; identifying and addressing quality of care and service issues, in conjunction with other Beacon Health Options departments; responding to provider complaints and questions as they arise; formulating provider report requests and participating in any local and/or national committees/meetings.

8.       Attends and participates in all mandatory meetings, which may include, but not limited to identifying training needs, gather relevant information verify and training material requirements are met in order to establish successful training outcomes.

9.       Records all complaints and grievances reported to Georgia Collaborative. Will track to resolution, and submit findings via monthly reporting.  Will support Quality Department with provider appeals as needed

10.   10% overnight and local travel

Position Requirements:  Bachelor’s degree in Business Administration, Science, Communications, or in a human services related area or combination Associates degree and experience considered in lieu of Bachelor’s degree is required.            

Relevant Work Experience:  At least three years of training, communications, or marketing experience required.  A minimum of two years in provider relations and/or a combination of managed care, behavioral healthcare, practice management and claims experience required.

Knowledge, Skills & Abilities:

•         Microsoft Office experience

•         Excellent written and verbal communication skills

•         Analytical skills

TO APPLY

Click below on “Apply for this Position” to create a profile and apply for the position

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

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.

PM16

#GD

#CB

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