Provider Relations Specialist - Health Plan Contracting

Sanford Health; North Dakota; Remote; USD 60,000 - 80,000; Full time

Job summary

A leading healthcare organization is seeking a Provider Relations Specialist to serve as the main liaison with network providers, ensuring effective communication and resolution of concerns. This full-time position offers opportunities for career development alongside a comprehensive benefits package, all while primarily working remotely with occasional onsite requirements.

Benefits

Health insurance

Dental insurance

Vision insurance

Life insurance

401(k) retirement plan

Generous time off package

Qualifications

• Strong understanding of Managed Care and provider reimbursement.
• Ability to handle pressure effectively while maintaining confidentiality.
• Capable of training others on policies and procedures.

Responsibilities

• Act as primary liaison between the Health Plan and network providers.
• Communicate daily with providers regarding questions and complaints.
• Support and maintain relationships with provider networks.

Skills

Communication

Diplomacy

Judgement

Education

Bachelor’s degree in Human Resources, Business or related field

Marketing/Sales training

Job description

Careers With Purpose

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.

Facility: Remote ND (Central Time)
Location: Remote, ND
Address:
Shift: Day
Job Schedule: Full time
Weekly Hours: 40.00
Salary Range: $21.50 - $34.50

Department Details

While this position is primarily remote, some in-person attendance will be required for trainings, team meetings, or special projects. These on-site responsibilities will be scheduled in advance.

Job Summary

The Provider Relations Specialist acts as the primary liaison between the Health Plan and its network providers, including physicians, hospital, and ancillary services. Responsible for daily communication with providers with respect to questions, concern, and complaints and therefore must have a broad understanding of the substantive and procedural aspects of the Health Plan. Knowledge of Managed Care-utilization management and provider reimbursement. Must be able to communicate effectively and with a high level of diplomacy with providers. Must assimilate large amounts of information to maintain a broad knowledge base. Should exercise good judgement in determining best methods of handling a variety of situations. Handles pressure effectively while maintaining confidentiality. Supports, develops and maintains relationships with provider networks. Responds to providers regarding policies, rates, changes, eligibility, credentialing etc. Occasionally train others regarding policies, procedures, online tools and other resources.

Qualifications

Bachelor’s degree in Human Resources, Business or related field required.

Marketing/Sales training preferred.

Benefits

Sanford Health offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit https://sanfordcareers.com/benefits .

Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to [e-mail] .

Sanford Health has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment.

Req Number: R-0220463
Job Function: General Administration
Featured: No