Provider Relations Rep II - Range Health

Blue Cross of Idaho; Town of Montana (WI); On-site; USD 66,000 - 93,000; Full time

Benefits offered by this job

Paid time off

Paid holidays

Insurance (medical/dental/vision/pharm

401(k) matching

Life insurance

Disability insurance

Education reimbursement

Employee assistance plan

Adoption assistance

Paid family leave

Job summary

Blue Cross of Idaho is seeking a Provider Relations Representative to establish and nurture a new provider network territory. You will engage with associations, deliver trainings via meetings, webinars, and on-site visits, and resolve contract and payment issues while coordinating with stakeholders to maintain policy compliance.

The role emphasizes educating providers on company policies, supporting cross-department initiatives, and onboarding new contracted providers.

Qualifications

• Experience: 8 years' provider service or health industry experience.
• Education: High School or equivalent.

Responsibilities

• Establish and maintain provider relationships for a new provider network in a new territory.
• Represent the company at association events and provide training education through provider meetings, presentations, webinars, virtual meetings and on-site visits.
• Coordinate the resolution of provider contracts, agreements, fee schedules, and payment problems.
• Collaborate with key stakeholders to identify and resolve issues.
• Coordinate resolution of contract or agreement issues. Communicate critical issues and provide recommendations to leaders.
• Educate providers on policies, procedures, practices, and data integrity.
• Coordinate cross departmental activities and projects to support and adhere to the provider contract requirements.
• Perform research to respond to inquiries and interpret policy and procedures to determine the most effective response.
• Provide welcome information to newly contracted providers and assist with on-boarding activities.
• Promote provider participation and utilization of on-line tools, provider resources and self - service programs.
• Perform other duties and responsibilities as assigned.

Skills

Provider relations experience

Healthcare industry experience

Communication skills

Education

High School diploma or equivalent

Job description

Who We Are

Range Health is a healthcare organization focused on expanding access to high-quality, affordable health coverage and care in underserved markets. As part of a long-term growth strategy, Range Health is helping bring Medicare products and services to communities in Idaho and Montana, with opportunities for future expansion into additional markets and offerings.

Range Health is a healthcare organization focused on expanding access to high-quality, affordable health coverage and care in underserved markets. As part of a long-term growth strategy, Range Health is helping bring Medicare products and services to communities in Idaho and Montana, with opportunities for future expansion into additional markets and offerings.

We Are Looking For a Provider Relations Rep With

• Experience: 8 years' provider service or health industry experience
• Education: High School or equivalent

What Your Day May Look Like

• Establish and maintain provider relationships for a new provider network in a new territory.
• Represent the company at association events and provide training education through provider meetings, presentations, webinars, virtual meetings and on-site visits.
• Coordinate the resolution of provider contracts, agreements, fee schedules, and payment problems.
• Collaborate with key stakeholders to identify and resolve issues.
• Coordinate resolution of contract or agreement issues. Communicate critical issues and provide recommendations to leaders.
• Educate providers on policies, procedures, practices, and data integrity.
• Coordinate cross departmental activities and projects to support and adhere to the provider contract requirements.
• Perform research to respond to inquiries and interpret policy and procedures to determine the most effective response.
• Provide welcome information to newly contracted providers and assist with on-boarding activities.
• Promote provider participation and utilization of on-line tools, provider resources and self - service programs.
• Perform other duties and responsibilities as assigned.

As of the date of this posting, a good faith estimate of the current pay range is $66,353 - $92,894. The position is eligible for an annual incentive bonus (variable depending on company and employee performance).

The pay range for this position takes into account a wide range of factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, travel requirements, internal equity, business or organizational needs, and alignment with market data. At Blue Cross of Idaho, it is not typical for an individual to be hired at or near the top range for the position. Compensation decisions are dependent on factors and circumstances at the time of offer.

• paid time off
• paid holidays
• community service and self-care days
• medical/dental/vision/pharmacy insurance
• 401(k) matching and non-contributory plan
• life insurance
• short and long term disability
• education reimbursement
• employee assistance plan (EAP)
• adoption assistance program
• paid family leave program

We will adhere to all relevant state and local laws concerning employee leave benefits, in line with our plans and policies.

Blue Cross of Idaho Health Service, Inc. is an independent licensee of the Blue Cross Blue Shield Association. For roles under Range Health, Ruby Analytics, or other non-licensed corporate entities: These services and products are managed or delivered by separate operating units or affiliates which are independent from, and not licensed by, the Blue Cross Blue Shield Association.

Reasonable accommodations

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.