Idaho Provider Relation Consultant

Gainwell Technologies LLC

86d•Remote

About The Position

Provider Relation Consultants work as the primary liaison between Gainwell Technologies, Idaho Department of Health & Welfare (Medicaid Division) and the Idaho Medicaid provider community (direct physicians, groups, organization administrators, compliance officers, billers, and credentialing staff). This position is responsible for building, maintaining, and promoting positive relationships through a vast array of consistent engagement with key stakeholders. Delivering the highest quality end-to-end service via training, concise timely response to inquiries, site visits and group presentations are requirements of this role. Your role in our mission Seeks resolution to issues reported; educate, investigate, respond, and document inquiries from the provider community and State partners within response time standards. Actively promote communication with medical partners in outreach efforts Develop, maintain, and deliver education materials to providers, Associations, internal and contract management staff in group and individual settings. Provides training in several venues: one on one, large provider group sessions, virtual meetings via TEAMS or Skype, community workshops and large presentation conferences. Understands the business of the client and related market dynamics; applies knowledge to ensure best practice procedures and continuous process improvement. Identifies issues and reviews, recommends, and implements modifications to procedures and workflow as necessary to ensure efficient and effective processing of transactions. What we're looking for Highly motivated self-started with six or more years of experience with business process, service delivery and improvement, preferably in an outsourcing environment. 3+ years’ experience working in healthcare industry and/or functional area. Strong Microsoft Office skills and experience working with business solutions software. Instructor level training and presentation delivery, experienced in developing and delivering training in large in-person and remote technology mediums. Proven experience with issue resolution focused on claims research, provider enrollment, requirement compliance and customer service. Ability to investigate complex inquiries while leveraging requirements to promote successful outcomes. Strong written and verbal communication skills. Strong computer and business solutions software skills. Proficient knowledge of Microsoft Office. Strong organization and time management skills What you should expect in this role Fast-paced, high volume, high visible position requiring attention to detail, delivering documented high quality customer service and support, within specific service level agreement timelines and standards. Performs site visits to providers office in accordance with Service Level Agreements via remote conference tools and/or onsite. Investigates complex inquiries, identifies resolutions, provides support and response to internal and external customers via secure message, email, and verbal communication. Captures and documents all inquiries and responses within the system tool. Travel is required to present and participate in various locations of Healthcare conferences, town halls, training venues and onsite meetings. Remote work from home position; however, business need could dictate onsite work in the future. Candidate must be physically located within the State of Idaho, within proximity to one of the Idaho Regions, Coeur d’Alene, Lewiston, Caldwell, Boise, Twin Falls, Pocatello or Idaho Falls.

Requirements

Highly motivated self-started with six or more years of experience with business process, service delivery and improvement, preferably in an outsourcing environment. 3+ years’ experience working in healthcare industry and/or functional area.
Strong Microsoft Office skills and experience working with business solutions software.
Instructor level training and presentation delivery, experienced in developing and delivering training in large in-person and remote technology mediums.
Proven experience with issue resolution focused on claims research, provider enrollment, requirement compliance and customer service. Ability to investigate complex inquiries while leveraging requirements to promote successful outcomes.
Strong written and verbal communication skills. Strong computer and business solutions software skills. Proficient knowledge of Microsoft Office. Strong organization and time management skills
Fast-paced, high volume, high visible position requiring attention to detail, delivering documented high quality customer service and support, within specific service level agreement timelines and standards.
Performs site visits to providers office in accordance with Service Level Agreements via remote conference tools and/or onsite.
Investigates complex inquiries, identifies resolutions, provides support and response to internal and external customers via secure message, email, and verbal communication. Captures and documents all inquiries and responses within the system tool.
Travel is required to present and participate in various locations of Healthcare conferences, town halls, training venues and onsite meetings.
Remote work from home position; however, business need could dictate onsite work in the future. Candidate must be physically located within the State of Idaho, within proximity to one of the Idaho Regions, Coeur d’Alene, Lewiston, Caldwell, Boise, Twin Falls, Pocatello or Idaho Falls.

Responsibilities

Seeks resolution to issues reported; educate, investigate, respond, and document inquiries from the provider community and State partners within response time standards.
Actively promote communication with medical partners in outreach efforts
Develop, maintain, and deliver education materials to providers, Associations, internal and contract management staff in group and individual settings.
Provides training in several venues: one on one, large provider group sessions, virtual meetings via TEAMS or Skype, community workshops and large presentation conferences.
Understands the business of the client and related market dynamics; applies knowledge to ensure best practice procedures and continuous process improvement. Identifies issues and reviews, recommends, and implements modifications to procedures and workflow as necessary to ensure efficient and effective processing of transactions.