Hybrid Behavioral Health Provider Relations Specialist

UPMC; Pittsburgh (Allegheny County); Hybrid; USD 55.000 - 75.000; Vollzeit

Zusammenfassung

UPMC Community Care Behavioral Health seeks a full-time Provider Relations Representative to join the Network Management team in downtown Pittsburgh. This hybrid role requires three in-office days per week with some travel to provider sites.

You will manage an assigned panel of providers and support additional caseloads as needed. You will ensure providers are informed about policies, credentialing, contracting, claims and authorizations, and understand differences among product lines.

Qualifikationen

• Experience in behavioral health provider relations preferred.
• Ability to navigate credentialing and contracting processes.
• Strong communication and problem-solving skills.

Aufgaben

• Build and maintain relationships with external providers across assigned caseload.
• Serve as primary contact for providers and support additional caseloads as needed.
• Ensure providers understand policies, credentialing, contracting, claims and authorization functions.
• Explain differences among product lines and provider obligations.
• Develop provider manuals and handbooks with input from staff and advisory groups.
• Create and implement actions in response to provider service calls.
• Participate in provider orientation and follow-up with assigned group.
• Distribute educational materials and ensure providers have current copies of billing handbooks.

Kenntnisse

Provider relations

Healthcare network experience

Customer service

Jobbeschreibung

UPMC Community Care Behavioral Health seeks a full-time Provider Relations Representative to join the Network Management team in downtown Pittsburgh. This hybrid role requires three in-office days per week with some travel to provider sites.

You will manage an assigned panel of providers and support additional caseloads as needed. You will ensure providers are informed about policies, credentialing, contracting, claims and authorizations, and understand differences among product lines.