Description:
• Acts as the primary resource for assigned providers or groups to establish, oversee, and maintain positive relationships
• Assists with or responds to complex issues regarding policies and procedures, plan design, contract language, service, claims or compensation issues
• Optimizes interactions with assigned providers and internal business partners to establish productive professional relationships
• Monitors service capabilities and collaborates cross-functionally to ensure that needs of constituents are met
• Supports or assists with operational activities including database management and contract coordination
• Educates providers as needed to ensure compliance with contract policies and parameters
• Meets with key providers periodically to ensure service levels are meeting expectations
• Collaborates on implementation of large provider systems to manage cost drivers and execute specific cost initiatives
• Conducts standard provider recruitment, contracting, or re-contracting activities and assists with more complex contracting discussions
• May provide guidance and training to less experienced team members
Requirements:
• 3+ years’ experience in business segment environment servicing providers with exposure to benefits and/or contract interpretation
• Working knowledge of business segment specific codes, products, and terminology
• 3-5 years’ experience with business segment specific policy, benefits, plan design and language
• Strong verbal and written communication, interpersonal, problem resolution and critical thinking skills
Benefits:
• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs including wellness screenings, tobacco cessation and weight management programs
• Confidential counseling and financial coaching
• Paid time off
• Flexible work schedules
• Family leave
• Dependent care resources
• Colleague assistance programs
• Tuition assistance
• Retiree medical access
• Many other benefits depending on eligibility