Provider Relations Specialist - Health Plan Contracting

Sanford Health; South Dakota; Remote; Full time

Job summary

Join a leading not-for-profit health system's Provider Relations team as a Specialist. This role offers you the chance to build relationships with network providers while handling queries and maintaining their satisfaction. With competitive benefits and the opportunity for advancement, it's a great step in your career.

Benefits

Health insurance

Dental insurance

Vision insurance

401(k) retirement plan

Generous time off package

Qualifications

• Must have a broad understanding of Managed Care.
• Marketing/Sales training preferred.

Responsibilities

• Acts as the primary liaison between the Health Plan and network providers.
• Handles inquiries regarding policies, rates, and credentialing.
• Responds to provider concerns with diplomacy.

Skills

Communication

Interpersonal Skills

Judgment

Education

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

Job description

Provider Relations Specialist - Health Plan Contracting

Join to apply for the Provider Relations Specialist - Health Plan Contracting role at Sanford Health

Provider Relations Specialist - Health Plan Contracting

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Join to apply for the Provider Relations Specialist - Health Plan Contracting role at Sanford Health

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.

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 SD (Central Time)

Location: Remote, SD

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

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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