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Provider Relations Representative
Manages all aspects of provider relations within a specified geographic region. Regularly visits and maintains ongoing contact with existing/potential providers for relationship building, recruitment, credentialing, re-credentialing and assisting with provider issues and education. Works under general supervision.
Compensation:
$30.71 - $38.41 Hourly
What We Provide
- Referral bonus opportunities
- Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays
- Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
- Employer-matched retirement saving funds
- Personal and financial wellness programs
- Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
- Generous tuition reimbursement for qualifying degrees
- Opportunities for professional growth and career advancement
- Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities
- Interdisciplinary network of colleagues through the VNS Health Social Services Community of Professionals.
What You Will Do
- Manages all provider contracts in designated territory, including recruitment, credentialing, recredentialing and relationship maintenance through regular visits and ongoing contact with existing and potential providers.
- Prepares materials for and orient providers to contract terms and operating requirements, Health Plan program and eligibility requirements, and service coordination.
- Collaborates with the Network Development and Contracting and Service Operations departments to administer demographic changes and renewals to provider contracts.
- Monitors contract performance of network providers and serves as a liaison between the Health Plan and the Provider to ensure the flow of information regarding resolution of member service issues.
- Coordinates provider site visits, as needed.
- Coordinates and attends meetings to serve as a resource and addresses provider issues.
- Updates and maintains provider manuals with current Health Plan policies and procedures.
- Updates and proofs provider directories.
- Assists providers in triaging billing and claims disputes.
- Participates and collaborates with Compliance on Department of Health and internal audits.
- Participates in special projects and performs other duties as assigned.
Qualifications
Licenses and Certifications:
- Driver's license, required
Education:
- Bachelor's Degree or equivalent related work experience, preferably in health care setting, required
Work Experience:
- Minimum three years health care experience, required
- Knowledge of government programs, including Medicare and Medicaid, preferred
- Prior experience in Provider Relations, preferred
- Reliable transportation to work sites, required
About Us
VNS Health is one of the nation’s largest nonprofit home and community-based health care organizations. Innovating in health care for more than 125 years, our commitment to health and well-being is what drives us—we help people live, age and heal where they feel most comfortable, in their own homes, connected to their family and community. On any given day, more than 10,000 VNS Health team members deliver compassionate care, unparalleled expertise and 24/7 solutions and resources to the more than 43,000 “neighbors” who look to us for care. Powered and informed by data analytics that are unmatched in the home and community-health industry, VNS Health offers a full range of health care services, solutions and health plans designed to simplify the health care experience and meet the diverse and complex needs of the communities and people we serve in New York and beyond.
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Mission & Values
As a team member of VNS Health, you share a passion for improving the health of patients through best-in-class care in the home and the community.
Inclusive Culture
At VNS Health, our priority is to create an environment where every team member feels they belong and are included.
Total Rewards
We provide our team members a well-rounded employment experience, competitive compensation, and a robust and affordable benefits package that serves you and your family. Our Total Rewards Program at VNS Health is an investment in your health, wealth and life.
