Provider Relations Representative, Sr. jobs in Nevada
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)
Recently Added Provider Relations Representative, Sr. jobs
Provider Relations Representative
- Prominence Health
-
Las Vegas, NV
FULL_TIME
-
Responsibilities
Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.
Learn more at: https://prominence-health.com/
Job Summary: Provider Relations Representative is responsible for assisting in the full range of provider relations and service interactions for all lines of business within Prominence Health Plan. Will assist in the design and implementation of programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers. Supports those who direct and implement strategies relating to the development and management of a provider network, identifying gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs, and may also be involved in identifying and remediating operational short-falls and researching and remediating claims; and is responsible for steerage initiatives, site visits, training, educating, and overall communications including portals, webpages, letters, and email messages. Responsible for the oversight and management of Medicare Quality Reporting during each performance year and through the annual reporting periods and ensures resources are in place to complete the annual GPRO reporting requirement.
Benefit Highlights- Loan Forgiveness Program
- Challenging and rewarding work environment
- Competitive Compensation & Generous Paid Time Off
- Excellent Medical, Dental, Vision and Prescription Drug Plans
- 401(K) with company match and discounted stock plan
- SoFi Student Loan Refinancing Program
- Career development opportunities within UHS and its 300 Subsidiaries!
- More information is available on our Benefits Guest Website: benefits.uhsguest.com
One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com
Qualifications
Qualifications and Requirements:- BS, Bus Admin, Finance or similar field, or equivalent work history
- 2 years in HEDIS, ACO, or Care Gap reporting
- 2 years working with Medicare contracts and regulatory reporting requirements
- 3 years in managed care or medical insurance.
- 2 years working in a clinical setting.
- 1 year in a claims, customer service or provider support role.
- Excellent oral and written English communication skills including telephone etiquette.
- Superior interpersonal skills
- Proficient research, critical-thinking and analytical problem-solving skills
- Intermediate proficiency with Microsoft Office (Excel, Word, PowerPoint, Outlook).
- Self-starter and resourceful with ability to execute projects in a fluid and fast paced environment
- Strong organizational, planning and attention to detail skills.
- Valid Driver’s License, reliable transportation, and proof of insurance required
- Requires local travel and occasional out of area overnight travel required.
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
Avoid and Report Recruitment Scams
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS
and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.
If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.
If you would like to learn more about the opportunity, please contact Bridget Gomez at: bridget.gomez@uhsinc.com - 18 Days Ago
Provider Relations Representative
- UHS
-
LAS VEGAS, NV
FULL_TIME
- Responsibilities Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Pr...
- 18 Days Ago
Manager, Provider Relations
- Prominence Health
-
Reno, NV
FULL_TIME
- Responsibilities: Job Summary: The Provider Relations Manager is responsible for the satisfaction of Prominence Health Plan participating providers through managing a staff of representatives that bui...
- 14 Days Ago
Sr. Manager, Provider Network
- Universal Health Services, Inc.
-
Reno, NV
FULL_TIME
- Responsibilities Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Pr...
- 14 Days Ago
Sr. Manager, Provider Network
- UHS
-
RENO, NV
FULL_TIME
- Responsibilities Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Pr...
- 16 Days Ago
Nephrologist
- Provider
-
Reno, NV
FULL_TIME
- Renown Health, Northern Nevada's largest and only not-for-profit healthcare network, is hiring a Transplant Nephrologist . Join our newly established Transplant Surgery Department with Renown Medical ...
- 1 Day Ago
Provider Relations Representative, Sr. jobs at Popular Companies
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
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
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
Provider Relations Representative
- American Health Plans
-
Milledgeville, GA
- American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Instituti...
- 6/10/2024 12:00:00 AM
Customer Relations Representative
- Cashdollar Insurance Agency Inc
-
North Versailles, PA
- Job Description Job Description Are you outgoing and customer-focused? Do you enjoy working with the public? If you answ...
- 6/10/2024 12:00:00 AM
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
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
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
About Nevada
Nevada is almost entirely within the Basin and Range Province, and is broken up by many north-south mountain ranges. Most of these ranges have endorheic valleys between them, which belies the image portrayed by the term Great Basin.
Much of the northern part of the state is within the Great Basin, a mild desert that experiences hot temperatures in the summer and cold temperatures in the winter. Occasionally, moisture from the Arizona Monsoon will cause summer thunderstorms; Pacific storms may blanket the area with snow. The state's highest recorded temperature was 125 °F (52 °C) in Laughlin (e...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Relations Representative, Sr. jobs
$72,140 to $89,463
Most Popular Cities in Nevada for Provider Relations Representative, Sr. Jobs
What does a Provider Relations Representative, Sr. do?
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