Provider Relations Representative

Umpqua Health•Roseburg, OR

12d•$54,000 - $65,000•Remote

About The Position

Umpqua Health is a Coordinated Care Organization (CCO) in Roseburg, Oregon that connects over 40,000 Douglas County OHP members to physical, dental, and behavioral health services and benefits through an integrated network of providers. Umpqua Health is currently seeking a Provider Relations Representative to join our team. Provider Relations Representative Status: Full Time Schedule: Monday - Friday 8:00-5:00PM Pacific Standard Time Salary Range: (Wage Band 16) $54,000 - $65,000 (Salary is dependent upon skill, education, and experience) Location: Remote (Occasional travel to Roseburg or nearby locations) Total Rewards Package: Health, Dental, Vision, Life, 401K, Paid Time Off, Tuition Assistance, Fitness Reimbursement, and more! Must have reliable transportation Purpose: The purpose of the Provider Relations Representative is to support our provider network and drive excellence in care delivery by serving as a service-driven and relationship-oriented liaison between Umpqua Health and our healthcare providers. In this highly collaborative role, you will ensure that provider needs are met, concerns are addressed, and organizational standards are consistently upheld. Success in this position requires strong communication skills, keen attention to detail, and the ability to thrive in a dynamic and evolving healthcare environment.

Requirements

Bachelor’s degree in related field, or equivalent experience.
3 years of provider relations, healthcare administration, health plan operations, or related field.
Knowledge of health plan operations, Managed Care, Coordinated Care Organizations.
Advanced proficiency in Microsoft Office tools, capability to learn new software.
Proficiency in data collection, survey analysis and performance reporting.
Detail oriented, able to multitask and prioritize multiple competing deadlines.
No suspension/exclusion/debarment from participation in federal health care programs (eg. Medicare/Medicaid)
Must have reliable transportation

Nice To Haves

Project management experience.
Ability to work independently and take the lead on assigned projects.
Team players with a collaborative mindset and commitment to health equity and community care.
Proficient computer skills, including MS Office suite
Experience considering the impacts of the work on multiple communities, including communities of color, in technical analysis.
Experience working on a diverse team
Experience working with different communication styles
Bi-lingual translation or translation capabilities a plus

Responsibilities

Develop, implement and deliver provider training programs that promote high-quality, compliant care.
Be the direct contact for providers when issues arise, need education or resources, help navigate contract agreements.
Build and maintain positive working relationships with colleagues and provider personnel.
Coordinate and participate in community provider events.
Distribute notices and updates to the provider network.
Answer questions and provide education.
Project work, as assigned.
Participate in internal and external audits as needed.
Communicate provider demographic information changes to appropriate personnel and ensure changes were made correctly.
Perform provider orientations and ongoing provider education, including onboarding and updating orientation materials.
Collaborate with internal stakeholders on process improvement initiatives focused on enhancing the providers’ ability to meet network standards and the overall provider experience.
Travel to off-site meetings and events as necessary.
Comply with organization’s internal policies and procedures, Code of Conduct, Compliance Plan, along with applicable Federal, State, and local regulations.
Perform other duties as assigned to support Umpqua Health’s Vision, Mission, and Organizational Values.