Provider Relations Specialist (Remote Option within SHP Service Area)

Marshfield Clinic Health System • Marshfield, WI

11d • Remote

About The Position

The Provider Relations Specialist works in cooperation with the Contracting Manager – Marshfield Clinic Health System Provider Network and other department and organization colleagues to deliver superior service to our comprehensive network of affiliated health care providers. This individual serves as the primary liaison between Security Health Plan (SHP) and affiliated providers for escalated and contractual issues across various lines of business, with limited supervision. The Provider Relations Specialist is responsible for relationship management activities for hospital, professional, vendor, care system and/or ancillary providers including: development and execution of issue escalation strategies, educational programs, onsite visit criteria, special initiatives, and building and preserving strong provider relationships

Requirements

• Associate degree or 60+ credits in health care, business, marketing, education, or related field.
• Three years’ experience in a medical group practice or health insurance/Health Maintenance Organization (HMO) environment.
• Experience with healthcare claims and insurance reimbursement methods, and understanding of contract terminology.
• Working knowledge of health care delivery systems and concepts of managed care.
• Demonstrated proficiency with the Microsoft Office suite.
• Excellent written and verbal communication skills.
• Demonstrated ability to take initiative, utilize critical thinking, and bring forth solutions to identified issues.

Nice To Haves

• Bachelor's degree in business administration, accounting, health care, finance, or related field.
• Experience in provider relations, including well-defined communication skills and a demonstrated aptitude for communicating with both business users and technical staff.
• Strong interpersonal, problem solving and relationship building experience.
• Credentialing or claims experience preferred.

Responsibilities

• development and execution of issue escalation strategies
• educational programs
• onsite visit criteria
• special initiatives
• building and preserving strong provider relationships

Benefits

• Positions listed as 30 hours per week or greater are offered the level 1 benefit package.
• Positions listed as 20 – 29 hours per week are offered the level 2 benefit package.
• Positions listed as less than 19 hours per week are non-benefited.
• Benefits for temporary positions vary. Details will be discussed in the interview process.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees