Provider Relations Representative, Behavioral Health
Phoenix AZ 85034
Job DescriptionThe Provider Relations Representative interacts with providers to promote the company and services while developing, maintaining and improving relationships within the provider community. He/she provides education, responds to provider questions and concerns and resolves any outstanding issues in partnership with other health plan staff to achieve positive outcomes and/or improve mutual understanding.
- Provides orientation, training, education meetings, presentations, and focus groups to improve mutual understanding and enhance working partnerships with providers.
- Responds to all provider inquiries via phone, email, face-to-face.
- Provides field contact with provider network including the performance of provider education and network monitoring functions.
- Directs, monitors, trends, routine and long-standing provider complaints, claims, contracting, credentialing and other problems requiring health plan follow-up and resolution.
- Facilitates immediate resolution of red-flag provider issues that are customer, community, legal or contractual threats with internal staff/leadership as needed.
- Performs administrative site visits for high-volume providers on an ad-hoc basis.
- Assists in the development and management of weekly, monthly and quarterly report to customer.
General Job Information
TitleProvider Relations Representative, Behavioral Health
Job FamilyOperations Group
CountryUnited States Minor Outlying Islands
FLSA StatusUnited States of America (Exempt)
Recruiting Start Date2/15/2019
Date Requisition Created2/15/2019
EducationBachelors: Business Administration
License and Certifications - Required
License and Certifications - Preferred
Other Job Requirements
2+ years experience in Managed Care
- Bachelors Degree in Business or related field
- 2+ years experience in Behavioral Health
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled