Provider Partnerships Strategist

Independence Blue Cross; Philadelphia (Philadelphia County); On-site; USD 60,000 - 85,000; Full time

Job summary

Independence Blue Cross seeks a Provider Partnership Associate to support IDS and community providers across PA and DE. You will educate providers on new initiatives impacting claims payments, manage provider rosters, and research provider issues to achieve timely outcomes.

The role requires collaboration across departments to resolve complex provider concerns, maintain data tracking, and drive operational efficiency. Strong communication and multitasking are essential.

Qualifications

• Bachelor’s degree or equivalent work experience.
• Minimum five years’ progressive experience in a health-care related organization with provider networks, contracting, claims processing or managed care operations preferred.
• Knowledge of professional billing requirements, reimbursement methodology, IBC/AmeriHealth products, medical policy, and benefits.
• Proficiency with Outlook, Word, Access, and Excel (pivot tables, filters, formulas).
• Experience using multiple IBC systems and enGen applications (INSINQ, OCWA, OSCAR, 4UM, 310 Database, Provider Profiles, PGRS).
• Proven ability to conduct educational programs for small and large groups.
• Self-motivated with strong interpersonal, analytical, problem-solving, organizational, time-management, and communication skills.
• Ability to manage multiple priorities with limited supervision and interact with all management levels.

Responsibilities

• Support IDS and community providers, educating them on initiatives and policy changes affecting claims payments.
• Handle Provider Validation Roster requests and submission of necessary forms for roster validation.
• Conduct research and analysis of provider issues to achieve goals within timeframes.
• Maintain tracking databases with current statuses and next steps.
• Collaborate with departments to resolve complex provider issues and improve satisfaction.
• Provide recommendations to management for improving operational efficiency and reducing costs.
• Establish and maintain professional relationships with practice administrators, medical directors, and practitioners to ensure regulatory compliance.
• Complete assigned projects to support corporate initiatives and assist team members as needed.

Skills

Interpersonal skills

Analytical thinking

Problem solving

Multitasking

Written and verbal communication

Education

Bachelor’s degree or equivalent

Tools

Outlook

Word

Excel (Pivot tables)

Access

INSINQ (IBC system)

OCWA (IBC system)

OSCAR (IBC system)

4UM (IBC system)

310 Database

Job description

Independence Blue Cross seeks a Provider Partnership Associate to support IDS and community providers across PA and DE. You will educate providers on new initiatives impacting claims payments, manage provider rosters, and research provider issues to achieve timely outcomes.

The role requires collaboration across departments to resolve complex provider concerns, maintain data tracking, and drive operational efficiency. Strong communication and multitasking are essential.