Provider Relations Representative II, Michigan Residency Required

Karmanos Cancer Institute; Oregon (IL); Remote; USD 45,000 - 75,000; Full time

Job summary

An established industry player is seeking a dedicated Provider Relations Representative to enhance relationships with healthcare providers. This fully remote role requires a proactive individual to educate and service provider groups, ensuring alignment with the organization's goals. The ideal candidate will have a strong background in managed care claims operations, excellent communication skills, and the ability to foster effective relationships. Join a dynamic team committed to improving healthcare delivery and making a positive impact on community health.

Qualifications

• 3 years experience in servicing hospitals and physician organizations.
• Valid state driver's license and reliable transportation required.

Responsibilities

• Educate and service provider groups regarding the Plan and its subsidiaries.
• Develop and maintain communications with key administrative staff.

Skills

Provider Relations

Managed Care Claims Operations

Communication Skills

Relationship Management

Education

Associate Degree in Business or Health Care

High School Diploma/GED

Bachelor’s Degree in Business or Health Care

Job description

McLaren Health Care is a fully integrated health network committed to quality, evidence-based patient care with locations in Michigan and Indiana. The McLaren system includes 13 hospitals in Michigan, ambulatory surgery centers, imaging centers, a primary and specialty care physician network, commercial and Medicaid HMOs, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network and a wholly owned medical malpractice insurance company. McLaren operates Michigan’s largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, one of only 53 National Cancer Institute-designated comprehensive cancer centers in the U.S.

Provider Relations Representative II, Michigan Residency Required

We are looking for a Provider Relations Representative II, to join us in leading our organization forward.

McLaren Integrated HMO Group (MIG) is a fully owned subsidiary of McLaren Health Care Corporation and is the parent company of McLaren Health Plan in Michigan and MDwise, Inc. in Indiana. It is an organization with a culture of high performance and a mission to help people live healthier and more satisfying lives.

McLaren Health Plan and MDwise, Inc., subsidiaries of MIG, value the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plans can thrive.As an employee of MIG,you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members.

McLaren Health Plan is our Michigan-basedhealth plan dedicated to meeting the health care needs of each of our Michigan members. Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org .

MDwise is our Indiana-based health plan, working with the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise and Healthy Indiana Planhealth insurance programs. Learn more about MDwise, Inc. at https://www.mdwise.org/ .

Position Summary:

Responsible for the education and servicing of assigned provider groups regarding all aspects of the Plan and its subsidiaries. Responsible for assisting in the development of policy, procedures and educational materials for use with all Provider Programs and for the development of benchmarks to measure performance against the Plan’s goals.Establishes and maintains effective relationships with key administrative executive staff of contracted medical delivery entities (i.e. physician organizations, physician hospital organizations, faculty groups, large independent groups, hospitals, etc.).Responsible to develop and maintain routine communications with such groups, performing presentations, education, and other activities to support the Plan’s provider service goals.All duties are to be carried out in collaboration with the contracting staff and other key staff as appropriate.

This position is fully remote but must be available to travel to all regions of lower Michigan.

Equal Opportunity Employer of Minorities/Females/Disabled/Veterans

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Qualifications:

Required:

• Associate Degree in business, health care or related field.
• Three (3) years’ experience in servicing hospitals and/or physician organizations and their office staff with at least two (2) years’ experience in managed care claims operations or provider billing functions.
• Valid state driver’s license, reliable transportation and automobile insurance required and maintained throughout employment.

OR

• High School Diploma/GED.
• Five (5) years equivalent combination of college coursework and/or specific related experience in servicing hospitals and/or physician organizations, Managed Care claims operations, and provider billing functions.
• Valid state driver’s license, reliable transportation and automobile insurance required and maintained throughout employment.

Preferred:

• Bachelor’s Degree in business, health care or related field.
• Established relationships with providers in the Plan’s service areas.

Additional Information

• Schedule: Full-time
• Requisition ID: 25002896
• Daily Work Times: 8:30 am - 5:30 pm
• On Call: No

McLaren Health Care is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identification, age, sex, marital status, national origin, disability, genetic information, height or weight, protected veteran or other classification protected by law.

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McLaren Health Care is an Equal Opportunity Employer. Qualified applicants will receive consideration for employmentwithout regard to race, color, religion, sexual orientation, gender identification, age, sex, marital status,national origin, disability, genetic information, height or weight, protected veteran or other classificationprotected by law.