Provider Relations Specialist III

Kaiser Permanente • Pleasanton, CA

249d

About The Position

In addition to the responsibilities listed below, this position is also responsible for aiding the planning and development of provider satisfaction strategies to improve network relationships and enhance provider engagement; supporting the development of provider relations programs to facilitate effective provider communications and problem resolution; and creating and distributing standard media materials (e.g., articles and newsletters) and publications to providers independently; ensuring providers adhere to regulatory and contractual requirements; escalating standard and nonstandard compliance issues to appropriate parties; gathering materials to support organizational responses to regulatory audits; and beginning to deliver provider education and/or onboarding.

Requirements

• High School Diploma or GED.
• Five (5) years of experience in health care delivery or operations in a managed care environment, customer relationship management, or a directly related field.

Nice To Haves

• Knowledge of Written Communication.
• Knowledge of Compliance Management.
• Interpersonal Skills.
• Time Management.
• Quality Assurance Process.
• Computer Literacy.
• Trend Analysis.
• Business Relationship Management.
• Presentation Skills.
• Health Care Reimbursement.

Responsibilities

• Pursues effective relationships with others by proactively providing resources, information, advice, and expertise with coworkers and members.
• Listens to, seeks, and addresses performance feedback; provides mentoring to team members.
• Pursues self-development; creates plans and takes action to capitalize on strengths and develop weaknesses.
• Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work.
• Completes work assignments autonomously by applying up-to-date expertise in subject area to generate creative solutions.
• Collaborates cross-functionally to solve business problems; escalates issues or risks as appropriate.
• Supports continuous improvement efforts by organizing provider, claims, and contracting data.
• Ensures contract commitments are met by organizing provider data in appropriate data platforms.
• Supports contract strategy development by executing tasks to support strategies that improve access to patient care.
• Supports the growth of the Provider Network by researching and evaluating potential partners/alliances.
• Contributes to provider satisfaction by consulting on issues that arise from contract configuration/interpretation.

What This Job Offers

• Industry: Ambulatory Health Care Services
• Education Level: High school or GED