Provider Relations Representative
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About The Position
The Provider Relations Representative plays a crucial role in leading, engaging, and facilitating the development of CenCal Health's provider network. This position is primarily responsible for recruitment, contracting, communication, and fostering relationships that align with the strategic objectives of the organization. The representative advocates for providers, manages appeals, recruits new providers, and educates them on the services offered by CenCal Health. Additionally, the role involves maintaining and improving provider participation and satisfaction through various initiatives and support mechanisms. In this position, the representative will research, analyze, and coordinate the resolution of complex provider concerns, including assisting with grievances and issues that may arise. A significant aspect of the role is to assess the educational needs of providers and plan training sessions and workshops accordingly. The representative must be present in the community they serve, providing support to providers through various communication channels, including phone, email, and in-person visits. The Provider Relations Representative reports to the Provider Relations Manager and collaborates with all departments within CenCal Health. Externally, they interact with healthcare providers, their office staff, local public agencies, community organizations, and hospitals. This role is essential in ensuring that providers are well-informed about contractual terms, compliance, and any changes within the organization that may affect their operations.
