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    Provider Solutions Advisor II - MIAMI-FL, United States - Florida Blue

    Florida Blue
    Florida Blue MIAMI-FL, United States

    2 weeks ago

    Default job background
    Full time
    Description

    Jobs in Provider Solutions provide provider services/network management support to the provider community by serving as a liaison between the provider and the Company on education, reimbursement, administrative/medical policy and non-routine provider issues, by supporting network contracting by researching issues that may impact future provider negotiations or jeopardize network retention, and by assisting in the implementation of new initiatives, capabilities and processes.

    Your Purpose

  • Leverages business relationships with a mix of complex physician and provider specialties including large multi-specialty physician and provider groups, ancillary providers and ancillary facilities that change behaviors to create value for customers.
  • Contributes to the efficiency of the delivery system through offering and servicing a valued, integrated portfolio of business solutions.
  • Serves as an adviser and educator to providers as the health care industry transforms in order to impact improved performance outcomes.
  • Influences key stakeholders to advocate for and adopt effective policies, business processes, initiatives and capabilities.
  • Monitors and evaluates adoption, engagement and educational opportunities by analyzing data in order to positively influence outcomes.
  • Supports network contracting efforts by providing input on engagement/performance relative to network participation decisions and by acting as a conduit to share competitive intelligence, industry trends and environmental impacts to key business partners and stakeholders.
  • Coordinates solutions of critical non-resolved provider issues with internal business partners.
  • Identifies and supports continuous improvement initiatives which may lead to creating action plans.

    • Important To Know

  • Must reside in Miami, FL or surrounding area
  • Not 100% remote; 2-3 days a week visiting client/provider sites, strategizing, and maintaining provider relationships
  • Requires travel for meetings, trainings, etc.

    • What You Must Have

  • 3+ years related work experience in Health care experience with a focus in provider relationship, network management or provider office/hospital environments.
  • Related Bachelor's degree or additional related equivalent work experience
  • Experience in preparing and presenting training materials.
  • Experience in negotiating and influencing customer outcomes.
  • Experience with managing a territory and associated priorities, action plans and tasks.
  • Experience with collaborating and building relationships with multiple internal and external partners such as vendors, providers, etc.
  • Knowledge of MS Office applications including Word, PowerPoint and Excel Knowledge of all physician/provider payment and AFCS, methodologies/ contracts.

    • General Physical Demands

  • Exerting up to 10 pounds of force occasionally to move objects.
  • Jobs are sedentary if traversing activities are required only occasionally.

    • What We Offer
    As a Florida Blue employee, you will thrive in our Be Well, Work Well, GuideWell culture where being well as an individual, and working well as a team, are both important in serving our members and communities.

    To support your wellbeing, comprehensive benefits are offered. As an employee, you will have access to:

  • Medical, dental, vision, life and global travel health insurance;
  • Income protection benefits: life insurance, Short- and long-term disability programs;
  • Leave programs to support personal circumstances;
  • Retirement Savings Plan includes employer contribution and employer match;
  • Paid time off, volunteer time off, 10 holidays and two flexible Well-Being days
  • Additional voluntary benefits available and a comprehensive wellness program


    • Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for intern, part-time and seasonal employees may differ.

    To support your financial wellbeing, we offer competitive pay as well as opportunities for incentive or commission compensation. We also conduct regular annual reviews with pay for performance considerations for base pay increases.

  • Typical Annualized Hiring Range: $57,200 - $71,500
  • Annualized Salary Range: $57,200 - $93,000
  • Final pay will be determined with consideration of market competitiveness, internal equity, and the job-related knowledge, skills, training, and experience you bring.

    • We are an Equal Opportunity/Protected Veteran/Disabled Employer committed to creating a diverse, inclusive and equitable culture for our employees and communities.

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