Provider Relations Advocate
About The Position
The Provider Relations Advocate supports provider claims, call quality, physician portal usability, and services enhancements. The role contributes to programs that foster positive relationships among the health plan, providers, and practice managers; supports provider network development and management; and helps deliver education and training to external providers. It also identifies gaps in network composition and services to support network contracting and development teams. The position is based at 3300 N McColl Rd, McAllen, Texas, and requires travel within the market as needed (the posting states “50 - 75%25”). The role is scheduled Monday through Friday, 8:00 a.m. to 5:00 p.m. The annual salary range is $60,200 to $107,400 for full-time employment. Benefits and incentives are subject to eligibility requirements.
Requirements
- High school diploma or GED.
- At least 4 years of health care or managed care experience.
- At least 2 years of provider relations and/or provider network experience.
- At least 1 year of experience in claims processing and issue resolution.
- At least 1 year of experience with Medicare and Medicaid regulations.
- Intermediate proficiency with MS Office.
- Ability to travel as needed; the posting states “50 - 75%25.”
Nice To Haves
- Access to reliable transportation and a valid U.S. driver’s license.
- Bachelor’s degree in a related field.
Responsibilities
- Assist with end-to-end provider claims and help enhance call quality.
- Assist with efforts to improve the physician portal’s ease of use and future service enhancements.
- Contribute to designing and implementing programs that build and nurture positive relationships among the health plan, providers, and practice managers.
- Support development and management of provider networks.
- Help implement training and development of external providers through education programs.
- Identify gaps in network composition and services to assist network contracting and development teams.
- Travel within the market as needed; the posting states “50 - 75%25.”
Benefits
- Paid time off accrued starting with the first pay period.
- 8 paid holidays.
- Medical plan options.
- Health Spending Account or Health Savings Account participation.
- Dental insurance.
- Vision insurance.
- Life and AD&D insurance.
- Short-term disability coverage.
- Long-term disability coverage.
- 401(k) savings plan.
- Employee Stock Purchase Plan.
- Education reimbursement.
- Employee discounts.
- Employee Assistance Program.
- Employee Referral Bonus Program.
- Voluntary benefits, including pet insurance, legal insurance, and long-term care insurance.
- Performance rewards and incentive and recognition programs.
- Equity stock purchase and 401(k) contribution, subject to eligibility requirements.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
