Hybrid Behavioral Health Provider Relations Specialist

Pittsburgh Tomorrow; Pittsburgh (Allegheny County); Hybrid; USD 45.000 - 65.000; Vollzeit

Zusammenfassung

UPMC Community Care Behavioral Health is seeking a full-time Provider Relations Representative for the Network Management team in downtown Pittsburgh’s U.S. Steel Tower.

This hybrid role includes three in-office days per week with occasional travel to provider sites. The ideal candidate brings behavioral health experience and a commitment to high-quality care across the provider network, serving as the primary contact for an assigned caseload and supporting credentialing, contracts, and claims

Qualifikationen

• BA/BS in healthcare, human services or related field.
• 2 years of experience in a complex organizational environment.
• 2 years of experience in healthcare or managed care environment.
• Experience with behavioral health services or knowledge of the behavioral health provider system preferred.
• Excellent written and oral communication skills.
• Ability to clearly articulate standards of care and provider agreements.
• Independent problem solving with timely issue resolution.
• Knowledge of public and private delivery systems in behavioral health care.

Aufgaben

• Ensure providers meet clinical needs while complying with service delivery standards.
• Answer provider line and support the panel as assigned.
• Develop and maintain relationships with a defined panel of providers.
• Assist in developing provider manuals and handbooks with input from advisory groups.
• Develop and implement action plans in response to provider service calls.
• Support provider orientation and follow-up with assigned groups.
• Contribute to provider newsletters and educational materials.
• Distribute up-to-date billing handbooks and provider manuals to providers.

Kenntnisse

Excellent written and oral comms

Independent problem solving

Behavioral health delivery systems

Ausbildung

BA/BS in healthcare or related field

Jobbeschreibung

UPMC Community Care Behavioral Health is seeking a full-time Provider Relations Representative for the Network Management team in downtown Pittsburgh’s U.S. Steel Tower.

This hybrid role includes three in-office days per week with occasional travel to provider sites. The ideal candidate brings behavioral health experience and a commitment to high-quality care across the provider network, serving as the primary contact for an assigned caseload and supporting credentialing, contracts, and claims