Senior r Provider Network Representative
Core
Planning and directing provider recruitment and contracting activities; educating providers on plan benefits, policies, and reimbursement processes; resolving complex provider issues.
Role type
Senior provider network representative (field-based)
Builds
Provider networks and contracts for health insurance plans
Domain
Healthcare / Managed Care
Deliverable
client delivery
Required skills
Negotiation, contracting, provider relations, claims knowledge, customer service, training, travel
Preferred skills
Physician group/hospital relationship building, provider education, complex claims resolution, Medicaid/Medicare Advantage experience, healthcare contracting knowledge, territory management, BCBSTX system knowledge
Responsibilities
Recruit and contract with healthcare providers, educate providers on plan policies and reimbursement, resolve complex provider issues, serve as liaison between providers and internal partners, train network staff
Seniority
Senior, hands-on IC