Field Provider Relations Representative in Georgia

SKYGEN

99d

About The Position

We are seeking three self-driven rock stars with Medicaid experience for newly created positions due to successful program expansion. Two positions will be located around the Atlanta area and one in the southern part of Georgia. The role involves working in the field 3 to 4 days per week and from a home office the remainder of the time. You will provide support to specific markets by researching, collaborating with internal staff, and resolving issues for high-value providers.

Requirements

• Bachelor’s degree in a related field or equivalent years of experience.
• 3-5 years of job-related experience in provider relations, account management, or managed care.
• Excellent written and verbal communication skills.
• Ability to think strategically regarding market direction, provider needs, and client relationships.
• Ability to build and maintain collaborative working relationships with diverse individuals.
• Ability to exercise influence without formal authority.
• Ability to ensure timely problem resolution despite multiple priorities.
• Intermediate knowledge of Microsoft Office products including Word, Excel, and email.

Nice To Haves

• Bachelor’s Degree in Business or a related field.
• Experience in a managed care environment.
• Experience working in the field or with field issues.

Responsibilities

• Build and maintain relationships with provider networks and clients through regular communication and timely problem resolution.
• Develop training and presentation materials based on market needs.
• Host training sessions for new and existing providers to promote the use of the provider web portal and address procedural questions.
• Act as a resource for clients and providers to resolve complex claim issues.
• Utilize provider-related modules in the Enterprise System to research claim and reimbursement questions.
• Assess issues from provider offices and provide appropriate contacts for resolution.
• Recognize market deficiencies and network to obtain referrals for potential providers.
• Recruit potential providers and discuss contract terms or negotiations.
• Arrange care with out-of-network providers for single case agreements.
• Maintain contact with potential clients through networking events.
• Collaborate with internal sales staff to relay potential leads for sales opportunities.
• Maintain updated data on client-owned provider networks using automated systems.
• Coordinate and conduct provider advisory board meetings and town hall meetings.
• Identify community relationships and develop partnerships to increase visibility of client programs.
• Support Credentialing and Network Development strategies.

What This Job Offers

• Education Level: Bachelor's degree