Provider Relations Representative (Hudson Valley Region)

VNS Health; New York (NY); On-site; USD 66,000 - 80,000; Full time

Benefits offered by this job

Referral bonus opportunities

Generous paid time off (PTO) and 9 HOL

Health insurance plan for you and your

Employer-matched retirement savings

Personal and financial wellness

Pre-tax FSAs for healthcare and depend

Generous tuition reimbursement forqual

Opportunities for professional growth

Internal mobility and CEU credits

Job summary

VNS Health in New York state is seeking a Provider Relations Specialist to support its Upstate Network. You will assist with provider contracts, credentialing, and ongoing relationship management to ensure satisfaction and contract compliance.

This role requires at least one year in healthcare and a Bachelor's degree in Business or related field. You will visit providers on-site and virtually, coordinating communications, and supporting performance improvement initiatives.

Qualifications

• Bachelor's Degree in Business or equivalent related work experience, preferably in health care setting required
• Minimum one year of health care experience required
• Prior experience in Provider Relations and contracting preferred
• Knowledge of government programs, including Medicare and Medicaid preferred

Responsibilities

• Assists with creating provider contracts and contract amendments, including recruitment, contracting (Negotiates contractual terms, services and rates of reimbursement), credentialing, recredentialing and relationship maintenance through regular visits and ongoing contact with existing and potential providers.
• Prepares materials for providers and assist with understanding contract terms, program requirements, and service coordination.
• Supports the positive provider relationships with provider community by regular on-site and/or virtual/digital visits, communicating administrative and programmatic changes, and facilitating education and the resolution of provider issues.
• Coordinates provider site visits.
• Coordinates meetings to serve as a resource and addresses provider issues. Updates and maintains provider manuals with current Health Plan policies and procedures. Updates and proofs provider directories.
• Participates in special projects and performs other duties as assigned.

Skills

Provider relations

Contracting

Credentialing

Healthcare administration

Education

Bachelor's degree in Business or equivalent related work experience

Job description

Overview

Plays a key role in supporting our VNS Health Upstate Network. Assists with building relationships with providers, assisting with operational tasks (such as credentialing and claims), and coordinating the implementation of performance improvement strategies. Works closely with existing and potential providers to ensure their satisfaction. This position operates under general supervision.

What We Provide

• Referral bonus opportunities
• Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
• Employer-matched retirement saving funds
• Personal and financial wellness programs
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
• Generous tuition reimbursement for qualifying degrees
• Opportunities for professional growth and career advancement
• Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities

What You Will Do

• Assists with creating provider contracts and contract amendments, including recruitment, contracting (Negotiates contractual terms, services and rates of reimbursement), credentialing, recredentialing and relationship maintenance through regular visits and ongoing contact with existing and potential providers.
• Prepares materials for providers and assist with understanding contract terms, program requirements, and service coordination.
• Supports the positive provider relationships with provider community by regular on-site and/or virtual/digital visits, communicating administrative and programmatic changes, and facilitating education and the resolution of provider issues.
• Coordinates provider site visits.
• Coordinates meetings to serve as a resource and addresses provider issues. Updates and maintains provider manuals with current Health Plan policies and procedures. Updates and proofs provider directories.
• Participates in special projects and performs other duties as assigned.

Qualifications

Education: Bachelor's Degree in Business or equivalent related work experience, preferably in health care setting required

Work Experience: Minimum one year of health care experience required Prior experience in Provider Relations and contracting preferred Knowledge of government programs, including Medicare and Medicaid preferred

Pay Range

USD $66,300.00 - USD $79,800.00 /Yr.

About Us

VNS Health has been committed to meeting the needs of New Yorkers for over 130 years. We're one of the largest nonprofit home- and community-based health care organizations in the country, and today, more than 11,500 team members work together to make a difference in the lives of more than 99,000 patients and members on any given day.