Provider Relations Representative supports, develops and maintains service relationships with all participants (physicians, providers and administrators) of a provider network. Responds to electronic and direct inquiries from clients about policies, rates, changes, referrals, eligibility, credentialing, etc. Typically requires a bachelor's degree. Being a Provider Relations Representative typically reports to a supervisor or manager. The Provider Relations Representative works on projects/matters of limited complexity in a support role. Work is closely managed. To be a Provider Relations Representative typically requires 0-2 years of related experience. (Copyright 2024 Salary.com)
Location - Wichita KS
Find your fit. Ignite your passion. Change a life.
Everyone has a calling that shapes them, and it looks different for each person, but the passion remains the same. You can be an irreplaceable part of bringing hope to at-risk youth and families. When you come to work for EmberHope, you can create impact in a youth’s life. Even in the dark, there is still an ember of hope.
Where do you fit?
To be a successful Medicaid Liaison (Provider Relations) you must become able to do the following always:
Support the permanency and cross-over case management teams by troubleshooting Medicaid issues and interfacing with community stakeholders.
Serve as a liaison for the Company with the Managed Care Organizations (MCOs) as well as any specialty service providers that may offer unique services to our children, youth, and families.
Respond to MCO inquiries within 2 business days, via e-mail or phone, and document all correspondence in our electronic client record.
Serve as the credentialing specialist to ensure the therapists connected to this contract are credentialed with the MCOs.
Host quarterly meetings with external services providers to discuss any needs and system improvements that we can address to partner and serve our families better.
Conduct community stakeholders meetings.
Partner with the internal communications department to develop community messaging.
Follow Company Policy and Procedure and operate according to the Company’s Program Practice Guidelines.