Provider Relations Representative I

Job description

Overview To establish and maintain excellent relationships with the provider network in a specific geographic region, including healthcare practitioners, office staff, and administrators. Works closely to identify and resolve complex issues, provides education and staff training. Provides service and education via onsite visits and telephone. Assists providers with understanding Partnership HealthPlan of California's policies and procedures and assists with resolving issues that arise. Responsibilities: - Maintains regular schedule of provider office visits to ensure open lines of communication, answers questions, distributes information, and documents and follows-up on questions or concerns. Ensures each visit includes a well-documented Rep Visit Sheet. - Investigates and responds to provider concerns. Serves as neutral liaison between providers and Partnership departments in responding to questions and resolving issues. Assists with research and disposition of provider appeals and grievances. - Trains provider offices via onsite visits and by telephone regarding Partnership policies, procedures, and available resources. - Creates educational materials and formal presentations. -...