Provider Relations Representative II, Michigan - Michigan Residency Required
About The Position
We are looking for a Provider Relations Representative II, to join us in leading our organization forward. Mclaren Integrated HMO Group (MIG) is a fully owned subsidiary of McLaren Health Care Corporation and is the parent company of McLaren Health Plan in Michigan and MDwise, Inc. in Indiana. It is an organization with a culture of high performance and a mission to help people live healthier and more satisfying lives. McLaren Health Plan and MDwise, Inc., subsidiaries of MIG, value the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plans can thrive. As an employee of MIG, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members. Mclaren Health Plan is our Michigan-based health plan dedicated to meeting the health care needs of each of our Michigan members. Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org. MDwise is our Indiana-based health plan, working with the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise and Healthy Indiana Plan health insurance programs. Learn more about MDwise, Inc. at https://www.mdwise.org/. Position Summary: Responsible for the education and servicing of assigned provider groups regarding all aspects of the Plan and its subsidiaries. Responsible for assisting in the development of policy, procedures and educational materials for use with all Provider Programs and for the development of benchmarks to measure performance against the Plan's goals. Establishes and maintains effective relationships with key administrative executive staff of contracted medical delivery entitles (i.e. physician organizations, physician hospital organizations, faculty groups, large independent groups, hospitals, etc.). Responsible to develop and maintain routine communication with such groups, performing presentations, education and other activities to support the Plan's provider service goals. All duties are to be carried out in collaboration with the contracting staff and other key staff as appropriate. This is a hybrid position with requirements to come onsite as scheduled to the office in Flint, MI and onsite with assigned providers/events as needed. #LI-AK1
Requirements
- Associate Degree in business, health care or related field.
- Three (3) years' experience in servicing hospitals and/or physician organizations and their office staff with at least two (2) years' experience in managed care claims operations or provider billing functions.
- Valid state driver's license, reliable transportation, and automobile insurance required and maintained throughout employment.
- OR
- High School Diploma/GED
- Five (5) years' equivalent combination of college coursework and/or specific related experience in servicing hospitals and/or physician organizations, managed care claims operations, and provider billing functions.
- Valid state driver's license, reliable transportation and automobile insurance required and maintained throughout employment.
Nice To Haves
- Bachelor's Degree in business, health care or related field.
- Established relationships with providers in the Plan's service areas.
Responsibilities
- Education and servicing of assigned provider groups regarding all aspects of the Plan and its subsidiaries.
- Assisting in the development of policy, procedures and educational materials for use with all Provider Programs and for the development of benchmarks to measure performance against the Plan's goals.
- Establishes and maintains effective relationships with key administrative executive staff of contracted medical delivery entitles (i.e. physician organizations, physician hospital organizations, faculty groups, large independent groups, hospitals, etc.).
- Develop and maintain routine communication with such groups, performing presentations, education and other activities to support the Plan's provider service goals.
- All duties are to be carried out in collaboration with the contracting staff and other key staff as appropriate.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Industry
Hospitals
Education Level
Associate degree
Number of Employees
5,001-10,000 employees
