Provider Relations Representative, Sr. jobs in Indiana

Provider Relations Representative, Sr. supports, develops and maintains service relationships with all participants (physicians, providers and administrators) of a provider network. Responds to electronic and direct inquiries from clients about policies, rates, changes, referrals, eligibility, credentialing, etc. May provide guidance or expertise to less experienced representatives. Being a Provider Relations Representative, Sr. typically requires a bachelor's degree. Typically reports to a supervisor or manager. The Provider Relations Representative, Sr. gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Provider Relations Representative, Sr. typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)

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Network and Provider Relations Manager
  • CommuniCare Family of Companies
  • Indianapolis, IN FULL_TIME
  • Network and Provider Relations Manager

    CommuniCare Advantage, a member of CommuniCare Health Services, is currently recruiting a Network and Provider Relations Manager to support our Medicare Advantage plan in the state of Indiana.

    PURPOSE/BELIEF STATEMENT

    The Network and Provider Relations Manager is responsible for the execution of a strategic plan to recruit, service and support network providers in an assigned geographic area.

    BENEFITS

    As a CommuniCare employee you will enjoy competitive wages and PTO plans. We offer full time employees a menu of benefit options from life and disability plans to medical, dental, and vision coverage from quality benefit carriers. We also offer 401(k) with employer match and Flexible Spending Accounts. 

    QUALIFICATIONS AND EXPERIENCE REQUIREMENTS

    • Bachelor's degree and a minimum 5 years of experience working in network management and/or provider relations.
    • Must have a working knowledge of Medicare programs.
    • Must possess solid knowledge and understanding of managed care industry; and local market conditions.
    • Proficiency in MS Office Suite
    • Must possess valid driver's license.
    • Must be willing to travel within the service area at least 50% of the time

    KNOWLEDGE/SKILLS/ABILITIES

    • Must have integrity and a strong ethical compass.
    • Must be flexible, able to work independently, and able to achieve deadlines and deliverables with minimal supervision.
    • Must have strong communication skills and ability to work effectively with people coming from diverse cultural and professional perspectives.

    JOB DUTIES AND RESPONSIBILITIES

    • Develop the provider network through contract negotiations, relationship development, and servicing all provider types.
    • Develop and maintain positive provider relationships with provider community by regular on-site visits (may be virtual or in person as needed), communicating administrative and programmatic changes, and facilitating, education and the resolution of provider issues.
    • Serve as a knowledge and resource expert regarding the most complex provider issues impacting provider satisfaction, research and resolve the most complex provider issues for prompt resolution.
    • Provide assistance regarding education, contract questions and non-routine claim issues.

    About Us

    A family-owned company, we have grown to become one of the nation’s largest providers of post-acute care, which includes skilled nursing rehabilitation centers, long-term care centers, assisted living communities, independent rehabilitation centers, and long-term acute care hospitals (LTACH). Since 1984, we have provided superior, comprehensive management services for the development and management of adult living communities. We have a single job description at CommuniCare, "to reach out with our hearts and touch the hearts of others." Through this effort we create "Caring Communities" where staff, residents, clients and family members care for and about one another.

  • 1 Day Ago

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Provider Relations Project Coordinator - Remote
  • McLaren Health Care
  • Indianapolis, IN FULL_TIME
  • We are looking for a Provider Relations Project Coordinator to join us in leading our organization forward.McLaren Integrated HMO Group (MIG), a division of McLaren Health Care Corporation, is an orga...
  • 16 Days Ago

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Public Relations Intern
  • South Shore Public Relations
  • Northwest, IN INTERN
  • South Shore PR is thrilled to announce our first-ever internship call-out! As a local northwest Indiana business, we are thrilled to offer a PR internship opportunity to a current or incoming college ...
  • Just Posted

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Sr Provider Education & Outreach Professional
  • Humana
  • Indianapolis, IN FULL_TIME
  • Become a part of our caring community and help us put health first Humana Healthy Horizons in Indiana is seeking a Senior Provider Education & Outreach Professional to develop and grow positive, long-...
  • 16 Days Ago

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Public Relations Representative
  • John Force Racing, Inc.
  • Brownsburg, IN FULL_TIME
  • Public Relations RepresentativeRegular Full-TimeBrownsburg, IN or Yorba Linda, CA or RemoteJohn Force Racing is looking for a Public Relations Representative to manage the operational PR, media, and m...
  • 10 Days Ago

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Customer Relations Representative
  • Maverick Solutions Inc
  • Indianapolis, IN FULL_TIME
  • We have full-time openings available for Customer Relations Representatives and Customer Relationship Manager Trainees. Join us in servicing retail giants with a smile and a handshake, and help us dev...
  • 11 Days Ago

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Customer Relations Representative
  • Bruno
  • Oconomowoc, WI
  • Overview This position is responsible to serve customers via a call-center. Provide product and sales information, proce...
  • 6/11/2024 12:00:00 AM

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Guest Relations Representative
  • Six Flags Great Adventure
  • Jackson, NJ
  • Assist Guests with questions, comments, concerns they may have about their experience while visiting Six Flags. Resolve ...
  • 6/10/2024 12:00:00 AM

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Donor Relations Representative
  • Christus Health
  • Irving, TX
  • Description Summary: Responsible for gift processing and donor relations including: responding to all donor inquiries, r...
  • 6/10/2024 12:00:00 AM

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Customer Relations Representative
  • Olympus Executives
  • Garland, TX
  • Are you a dedicated, self-driven individual with a passion for providing outstanding customer support? Do you have a rep...
  • 6/10/2024 12:00:00 AM

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Customer Relations Representative
  • Upstate Niagara Cooperative, Inc.
  • Lancaster, PA
  • ** Customer Relations Representative** **Job Category****:** Customer Service **Requisition Number****:** CUSTO001807 Sh...
  • 6/10/2024 12:00:00 AM

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Customer Relations Representative
  • 3rd Degree Solutions
  • Roseville, CA
  • 3rd Degree Solutions is a fast-paced customer acquisition company dedicated to helping our clients expand their customer...
  • 6/8/2024 12:00:00 AM

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Patient Relations Representative
  • Gastro Health
  • Delray Beach, FL
  • Gastro Health is seeking a Full-Time Patient Relations Representative to join our team! Gastro Health is a great place t...
  • 6/7/2024 12:00:00 AM

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Team Relations Representative
  • Onin Staffing
  • Chattanooga, TN
  • Job Description Job Description The On-Site role will be based at a client site. This position is the primary liaison be...
  • 6/7/2024 12:00:00 AM

Indiana /ˌɪndiˈænə/ (listen) is a U.S. state located in the Midwestern and Great Lakes regions of North America. Indiana is the 38th largest by area and the 17th most populous of the 50 United States. Its capital and largest city is Indianapolis. Indiana was admitted to the United States as the 19th U.S. state on December 11, 1816. Indiana borders Lake Michigan to the northwest, Michigan to the north, Ohio to the east, Kentucky to the south and southeast, and Illinois to the west. Before becoming a territory, various indigenous peoples and Native Americans inhabited Indiana for thousands of ye...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Relations Representative, Sr. jobs
$69,697 to $86,433

Provider Relations Representative, Sr. in Duluth, MN
Held meetings with providers to review new policies, products and issue resolution.
January 14, 2020
Provider Relations Representative, Sr. in Norwich, CT
The continued upward spiral in health care costs has challenged sponsors, providers and payers of health benefits to deliver high quality care in the most cost-effective manner possible.
January 21, 2020
Provider Relations Representative, Sr. in Poughkeepsie, NY
The specific duties of customer service representatives vary by industry.
December 25, 2019