- Service Acknowledgement Form upon completion of each and every provider orientation session conducted.
- 5 years experience with a Medicare Advantage Health Plan or BS/BA DegreeCommitment to the Health Plans vision and missionExcellent communication skills, both in oral and writtenFully Bilingual English / Spanish (preferred)
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Provider Relations Representative
1 week ago
DOCTORS HEALTHCARE PLANS, INC. Coral Gables, United StatesPosition Purpose: · Exercise the duties and responsibilities delegated to the Provider Relations Representative with the outmost professionalism and dedication . · Responsibilities: · Responsible for conducting provider orientations of newly contracted providers within the speci ...
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Provider Relations Representative
3 weeks ago
DOCTORS HEALTHCARE PLANS, INC. Coral Gables, United StatesPosition Purpose: Exercise the duties and responsibilities delegated to the Provider Relations Representative with the outmost professionalism and dedicationResponsibilities:Responsible for conducting provider orientations of newly contracted providers within the specified time f ...
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Provider Relations Representative
2 weeks ago
DOCTORS HEALTHCARE PLANS, INC. Coral Gables, United StatesPosition Purpose: Exercise the duties and responsibilities delegated to the Provider Relations Representative with the outmost professionalism and dedication · Responsibilities: Responsible for conducting provider orientations of newly contracted providers within the specified t ...
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Customer Relations Representative
3 weeks ago
Kat Stevenson - State Farm Agent Hollywood, United States**Position Overview**: · Are you outgoing and customer-focused? Do you enjoy working with the public? If you answered yes to these questions, working for a State Farm independent contractor agent may be the career for you State Farm agents market only State Farm insurance and fin ...
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Customer Relations Representative
2 weeks ago
Manny Morin - State Farm Agent Miami FL Miami, United StatesJob Description · Job DescriptionPosition Overview · Are you outgoing and customer-focused? Do you enjoy working with the public? If you answered yes to these questions, working for a State Farm independent contractor agent may be the career for you State Farm agents market only ...
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Customer Relations Representative
3 weeks ago
Daniel Carrera - State Farm Agent Homestead, United States Full timePosition Overview · Successful State Farm Agent is seeking a qualified professional to join their winning team for the role of Customer Relations Representative - State Farm Agent Team Member. We seek an energetic professional interested in helping our business grow through value ...
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Concierge Representative-guest Relations-pt
3 weeks ago
Broward Health Medical Center Fort Lauderdale, United StatesBroward Health Medical Center · Shift: Shift 2 · FTE: · Summary: · Under general supervision and according to established policies and procedures, receives hospital visitors while providing world class customer service through professional communication via telephone and/or in p ...
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Provider Relations Representative
3 weeks ago
DOCTORS HEALTHCARE PLANS, INC. Miami, United StatesJob Description · Job DescriptionPosition Purpose: Exercise the duties and responsibilities delegated to the Provider Relations Representative with the outmost professionalism and dedication. · Responsibilities: · Responsible for conducting provider orientations of newly contract ...
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Provider Relations Representative
3 weeks ago
DOCTORS HEALTHCARE PLANS, INC. Miami, United StatesJob Description · Job DescriptionPosition Purpose: Exercise the duties and responsibilities delegated to the Provider Relations Representative with the outmost professionalism and dedication. · Responsibilities: · Responsible for conducting provider orientations of newly contract ...
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Alivi Miami, United StatesJob Description · Job DescriptionSUMMARYThe Provider Relations Representative serves as the primary liaison between Alivi and our network of optometrists and ophthalmologists. The Provider Relations Representative will provide training, education and guidance while building a str ...
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Alivi Miami, United StatesJob Description · Job DescriptionSUMMARYThe Provider Relations Representative serves as the primary liaison between Alivi and our network of optometrists and ophthalmologists. The Provider Relations Representative will provide training, education and guidance while building a str ...
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Patient Relations Representative
15 hours ago
Gastro Health Miami, United States**Gastro Health is seeking a Full-Time Patient Relations Representative to join our team** · Gastro Health is a great place to work and advance in your career. You'll find a collaborative team of coworkers and providers, as well as consistent hours. · **This role offers**: · - A ...
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Vendor Relations Representative
2 weeks ago
ClassWallet Hollywood, United StatesJob Description · Job DescriptionAbout ClassWallet · ClassWallet is a rapidly growing financial technology company currently selling into the K12 education market. We are revolutionizing how funds and procurement are managed for school systems amidst growing trends to decentrali ...
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Broward Health Medical Center Fort Lauderdale, United StatesBroward Health Medical Center · Shift: Shift 1 · FTE: · Summary: · Under general supervision and according to established policies and procedures, receives hospital visitors while providing world class customer service through professional communication via telephone and/or in p ...
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Customer Relations Representative
2 weeks ago
Jimmy Peralta - State Farm Agent Hollywood, United StatesJob Description · Job DescriptionPosition OverviewState Farm Insurance Agent located in Hollywood, FL is seeking an outgoing, career-oriented professional to join their team. As a State Farm team member for Jimmy Peralta - State Farm Agent, you will build and develop customer rel ...
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Provider Relations Representative
3 weeks ago
Ascendo Doral, United StatesProvider Relations Representative ACO, MSO, Managed Care, Medicare Advantage Plans ( Medicare related ) Open to Network Management Reps, Contracting or Credentialing Reps Field-based position -3 travel days within the territory/2 days remote Full time - Monday- Friday Must have a ...
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Patient Relations Outreach Representative
4 days ago
Palm Medical Centers North Miami Beach, United StatesJob Description · Job DescriptionOverview · The Patient Relations Outreach Representative will focus on enrolling new members with Medicare onto the practice by creating engagements in the community, guiding patients on health care coverage options, and developing strategic partn ...
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Provider Relations Representative Vision Network
2 weeks ago
Alivi Miami, United StatesJob Description · Job DescriptionSUMMARY · The Provider Relations Representative serves as the primary liaison between Alivi and our network of optometrists and ophthalmologists. The Provider Relations Representative will provide training, education and guidance while building a ...
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Patient Relations Representative
1 day ago
Gastro Health Fort Lauderdale, United StatesGastro Health is seeking a Full-Time Patient Relations Representative to join our teamGastro Health is a great place to work and advance in your career. You'll find a collaborative team of coworkers and providers, as well as consistent hours.This role offers: A great work/life ba ...
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Patient Relations Representative
2 weeks ago
Gastro Health Hollywood, United StatesGastro Health is seeking a Full-Time Patients Relations Representative to join our team · Gastro Health is a great place to work and advance in your career. You'll find a collaborative team of coworkers and providers, as well as consistent hours. · This role offers: A great wo ...
Provider Relations Representative - Coral Gables, United States - Doctors Healthcare Plans Inc.
Description
Position Purpose:
Exercise the duties and responsibilities delegated to the Provider Relations Representative with the outmost professionalism and dedication
Responsibilities:
Responsible for conducting provider orientations of newly contracted providers within the specified time frames as indicated in Policy & Procedure PR 01.Responsible for securing a signed Notice of Educational In
Responsible for maintaining original completed copies of the Notice of Educational In Service Acknowledgement Forms in the form and format adopted from time to time by the VP of Provider Relations.
Responsible for the dissemination of the Provider Handbook / Manual, Provider Bulletins, and applicable Policies and Procedures affecting the Health Plans Participating Network of Providers on a as needed basis.
Responsible for conducting the Annual Site Visit for PCPs and High-Volume Specialists within the established time frames as indicated on Policy & Procedure PR 02.Oversight of the participating provider accounts assigned to him/her by the VP of Provider Relations or her assigned designeeAdhere to the delineated Periodic Site Frequency Parameters as may be applicable to established PCPs and High-Volume SpecialistsComplete the PCP Provider Site Visit Tool to the extent required for each and every Annual and Periodic PCP site visit conducted within their assigned service areaComplete the Specialty Provider Site Visit Tool to the extent required for each and every Annual and Periodic Specialty site visit conducted within their assigned service areaConduct Provider After Hours surveys and periodically monitor the accessibility to access to care to ensure that it meets or exceeds such standards as may be established by CMS.Responsible for all communication and training materials distributed to participating providers is up to date.
Provide assistance in coordinating the Annual Medicare Advantage Health Plan Benefit presentation dinner meetings to Primary Care Physicians and others as needed.
Active participate in Quality Management Program initiatives and QI special projects as may apply.Actively participate in the implementation of special projects logistics reporting pertinent to Provider Corrective Action Plans, Provider Surveys, Provider claim dispute settlements, etc.
Effectively address all matters of Provider complaints and disputes as may be presented for resolution to the VP of Provider Relations.
Maintain accepted and expected level of proficiency in Federal and State regulatory subject matters as mandated through CMS, AHCA and other applicable agencies governing the operations of Medicare Advantage Plans.
Qualifications:
This description indicates, in general terms, the type and level of work performed and responsibilities held by the team member(s).
Duties described are not to be interpreted as being all-inclusive or specific to any individual team member.No Third Party Agencies or Submissions Will Be Accepted.
Our company is committed to creating a diverse environment.
All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
DFWPOpportunities posted here do not create any implied or express employment contract between you and our company / our clients and can be changed at our discretion and / or the discretion of our clients.
Any and all information may change without notice. We reserve the right to solely determine applicant suitability. By your submission you agree to all terms herein.What's your highest level of education completed? *How many years' experience do you have as a Provider Relations Representative? *How many years' experience do you have with a Medicare Advantage Health Plan? *Do you have working knowledge of CMS, AHCA and other federal and state current regulatory governing guidelines applicable to HMOs? * Yes NoAre you fluent in English and Spanish? (preferred) * Yes NoRate your level of proficiency with Excel, Word, Access, PowerPoint: *#J-18808-Ljbffr
Provider Relations Representative professionals in Coral Gables
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Aida Vasquez
Proactive Sales and Marketing Professional