Provider Relations Representative, Senior - Behavioral Health Call Center

Blue Shield of CA; San Diego (CA); Hybrid; USD 90,000 - 110,000; Full time

Job summary

Blue Shield of California is seeking a Senior Provider Relations Representative to join the Behavioral Health Network Management team. You will help reimagine how behavioral health services are delivered to Commercial, Medicare, and Medi-Cal members, while managing provider relations, resolving issues, and coordinating administrative tasks for a seamless provider experience.

This role supports a hybrid virtual work model with occasional in-office attendance based on business needs and

Qualifications

• Bachelor’s degree or HS diploma with 4+ years relevant experience.
• 5 years in a managed care setting with provider interaction.
• Excellent written and verbal communications.
• Strong analytical, time management, and organizational skills.
• Strong customer service and problem-solving skills.
• Proficiency in Outlook, Word, Excel, and Adobe Acrobat.
• Self-starter who works well independently or with a team.

Responsibilities

• Lead reimagination of how behavioral health services are delivered to Commercial, Medicare and Medi-Cal.
• Provide provider support, issue resolution, and relationship building.
• Coordinate administrative tasks to ensure a seamless provider experience.
• Collaborate with Behavioral Health Network Management and report to the manager.

Skills

Excellent communication

Analytical skills

Time management

Organizational skills

Customer service

Education

Bachelor's degree or High School Diploma/GED with 4 years of experience

Tools

Outlook

Word

Excel

Adobe Acrobat

Job description

Your Role

The Behavioral Health Network Management team is responsible for the state-wide behavioral health program at Blue Shield of California (BSC). This includes managing a directly contracted behavioral health provider network. The Provider Relations Representative, Senior will report to the Behavioral Health Provider Relations Manager. In this role you will be one of several team members who will be leading the effort to reimagine how we deliver behavioral health services to our Commercial, Medicare, and Medi-Cal membership. This behavioral health call center role combines provider support, issue resolution, relationship building, and administrative coordination to ensure a seamless provider experience.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience

• Requires a Bachelor's degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree
• Requires 5 years of prior relevant experience working in a managed care setting and interacting regularly with providers over the phone
• Excellent written and verbal communications skills
• Strong analytical skills, time management skills, and organizational skills
• Strong customer service and problem‑solving skills
• Proficiency in Outlook, Word, Excel, and Adobe Acrobat
• Self‑starter who works well independently or with a team

Hybrid Virtual Work

This role allows employees to work virtually full‑time, however employees will be expected to come to the office based on business need.