Provider Relations Representative, Sr. jobs in Saint Cloud, MN

Provider Relations Representative, Sr. 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. May provide guidance or expertise to less experienced representatives. Being a Provider Relations Representative, Sr. typically requires a bachelor's degree. Typically reports to a supervisor or manager. The Provider Relations Representative, Sr. gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Provider Relations Representative, Sr. typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)

H
Provider Relations Specialist - Minnesota Market (Hybrid)
  • Homeward
  • Saint Cloud, MN FULL_TIME

  • The Opportunity

    We are seeking a highly motivated Provider Relations Specialist responsible for field activities that provide education and support to providers in the Homeward service area. The Provider Relations Specialist will work with local providers to optimize quality and total cost of care performance based on health plan contractual arrangements.


    What You’ll Do:

    • An understanding of value-based care and risk-sharing methodology
    • Experience impacting cross-functional clinical and operational teams through informal leadership
    • Relationships within the Minnesota physician market and the ability to gain confidence and build partnerships within the same physician market
    • Develop trusted relationships and maintain open lines of communication with providers through in-person visits, emails, phone
    • Serve as primary contact for providers, serving as a liaison between the provider and Homeward
    • Experience with clinical and physician outreach activities - particularly with rural community resources -  to develop programmatic partnerships and referral management
    • Ability to gain access to decision-makers either by experience, reputation, or education
    • Exceptional project management, communication, and leadership skills
    • Willingness to travel daily within the rural counties of Minnesota for business development purposes
    • Experience with healthcare strategy and a passion for re-architecting how health and care are delivered
    • Conduct provider onboarding, orientation, and ongoing educational training throughout the year to optimize provider performance
    • Conduct regular face-to-face meetings with the providers, documenting discussions, issues, attendees, and action items covering claims issues, quality care gaps, CAHPS, the use of HCCs, and member and provider rosters
    • Collaborate with other departments to ensure provider inquiries are resolved in a timely and effective manner
    • Create detailed reporting of provider visits, inquiries, trainings, and growth opportunities
    • Collaborate with Homeward Navigators to ensure patients receive timely access to appropriate, high-quality care from assigned providers
    • Problem-solve and identify ways to address provider issues timely and effectively
    • Maintain and update provider rosters
    • Investigate and communicate provider changes
    • Work cross-functionally with internal departments
    • The position requires the use of high-speed internet
    • Must be able to travel frequently to the assigned service areas
    • Other duties assigned by department leaders

    What You Bring:

    • Bachelor’s degree or equivalent years of experience preferred
    • 2-3 years experience in provider network scope of services
    • Strong understanding of Managed Care Operations
    • Excellent written and verbal communication skills
    • Proficient computer skills and Microsoft Office programs (i.e., Outlook, Excel, Word, and PowerPoint)
    • Experienced in healthcare, provider engagement, Medicare, Medicaid, and Commercial managed care systems
    • Relentlessly resourceful. You enjoy taking ownership and can get things done without excuses. You are resilient, detail-oriented, and truly believe that no task is beneath you
    • Possess strong organizational skills, plan daily activities, and demonstrate initiative with minimal supervision to complete projects
    • Comfortable with ambiguity and biased towards action. You enjoy thinking about complex and ambiguous problems and can execute consistently and add compounding value
    • Comfortable working in a fast-paced environment
    • Strong priority management, working independently, effectively managing time and resources

    What Shapes Homeward:

    • Deep commitment to one another, the people and communities we serve, and to provide care that enables everyone to achieve their best health
    • Compassion and empathy
    • Curiosity, and an eagerness to listen
    • Drive to deliver high-quality experiences, clinical care, and cost-effectiveness
    • Strong focus on sustainability of our business and scalability of our services, to maximize our reach and impact
    • Nurturing a diverse workforce, with a wide range of backgrounds, experiences, and points of view
    • Taking our mission and business seriously, but not taking ourselves too seriously– having fun as we build!

    Benefits:

    • Competitive salary and equity grant
    • Unlimited PTO
    • Comprehensive benefits package including medical, dental & vision insurance with 100% of monthly premium covered for employees
    • Unlimited Paid Time Off
    • Company-sponsored 401k plan

    At Homeward, a diverse set of backgrounds and experiences enrich our teams and allow us to achieve above and beyond our goals. If you have yet to gain experience in the areas detailed above, we hope you will share your unique background with us in your application and how it can be additive to our teams.

    Homeward is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. Homeward is committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities.

  • 2 Days Ago

G
Outside Parts Sales Representative (SR)
  • GATR Truck Center
  • Sauk Rapids, MN FULL_TIME
  • GATR Truck Center seeking a motivated and results-driven Outside Parts Sales Representative to join our dynamic team in SAUK RAPIDS, MN. In this role, you will be responsible for generating new busine...
  • 20 Days Ago

J
Customer Relations Representative - State Farm Agent Team Member
  • Jason Tibbits - State Farm Agent
  • Litchfield, MN FULL_TIME
  • 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 ...
  • 19 Days Ago

M
Customer Relations Representative - State Farm Agent Team Member
  • Mick Quinn - State Farm Agent
  • Benson, MN FULL_TIME
  • 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 ...
  • 23 Days Ago

D
Customer Relations Representative - State Farm Agent Team Member
  • Dan Anderson - State Farm Agent
  • Saint Cloud, MN FULL_TIME
  • 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 ...
  • Just Posted

T
Customer Relations Representative - State Farm Agent Team Member
  • Tammie Downare - State Farm Agent
  • Saint Cloud, MN FULL_TIME
  • Position Overview State Farm Insurance Agent located in Saint Cloud, MN is seeking an outgoing, career-oriented professional to join their team. As a State Farm team member for Tammie Downare, you wil...
  • 11 Days Ago

Filters

Clear All

Filter Jobs By Location
  • Filter Jobs by companies
  • More

0 Provider Relations Representative, Sr. jobs found in Saint Cloud, MN area

S
Collection Officer, Finance and Technology Division, Human Services
  • Stearns County Mn
  • Saint Cloud, MN
  • Salary: See Position DescriptionLocation : St. Cloud MN, MNJob Type: Full-timeJob Number: 2024-01697Department: Human Se...
  • 4/28/2024 12:00:00 AM

A
Order Selector -FULL TIME
  • Associated Wholesale Grocers, Inc.
  • Saint Cloud, MN
  • Job Description *Schedule Includes Working the Weekends, 4 days on 3 days off- 10 hour shifts From $22-$24 Per Hour-Plus...
  • 4/28/2024 12:00:00 AM

D
Fuel Compliance Officer - 12 Month Roster
  • Department Of The Treasury
  • Saint Cloud, MN
  • DutiesWHAT IS THE SMALL BUSINESS SELF EMPLOYEDDIVISION DIVISION?A description of the business units can be found at: htt...
  • 4/28/2024 12:00:00 AM

F
Registered Nurse
  • Fresenius Medical Care
  • Saint Cloud, MN
  • PURPOSE AND SCOPE:The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical ...
  • 4/28/2024 12:00:00 AM

A
Senior Financial Analyst
  • Anderson Trucking Service Inc.
  • Saint Cloud, MN
  • Anderson Trucking Service, Inc. Senior Financial Analyst St. Cloud , Minnesota Apply Now Department: Administrative and ...
  • 4/28/2024 12:00:00 AM

S
Banking Relationship Specialist (Bilingual: Hmong)
  • Stearns Bank NA.
  • Saint Cloud, MN
  • Job Description Job Description Come Grow with Us and Join an Award-Winning Organization! Stearns Bank is looking for a ...
  • 4/27/2024 12:00:00 AM

T
PT Customer Service Representative - Work From Home>
  • Time4Learning
  • Saint Cloud, MN
  • [Customer Support / Fully Remote] - Anywhere in U.S. / Competitive pay / Ability to work east coast hours - As a Custome...
  • 4/26/2024 12:00:00 AM

A
National Sales Representative
  • Anderson Trucking Service, Inc.
  • Saint Cloud, MN
  • National Sales Representative Apply Now! Back to search Location: St. Cloud, MN Department: Sales, Customer Service and ...
  • 4/25/2024 12:00:00 AM

St. Cloud is a city in the U.S. state of Minnesota and the largest population center in the state's central region. Its population is 67,984 according to the 2017 US census estimates, making it Minnesota's tenth largest city. St. Cloud is the county seat of Stearns County and was named after the city of Saint-Cloud, France (in Île-de-France, near Paris), which was named after the 6th-century French monk Clodoald. Though mostly in Stearns County, St. Cloud also extends into Benton and Sherburne counties, and straddles the Mississippi River. It is the center of a small, contiguous urban area tot...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Relations Representative, Sr. jobs
$70,521 to $87,455
Saint Cloud, Minnesota area prices
were up 1.3% from a year ago

Provider Relations Representative, Sr. in Kingsport, TN
A job as a Provider Relations Representative falls under the broader career category of Business Operations Specialists, All Other.
February 18, 2020
Provider Relations Representative, Sr. in Sioux City, IA
The PR Rep serves as a liaison between contracted payers, providers and ancillary providers to promote superior customer service and seamless programs.
February 16, 2020
Provides telephonic provider education to new providers.
February 14, 2020
Provider Relations Representative, Sr. in Buffalo, NY
This position provides on-going communication, in-service, orientation, and direction to these contracted provider offices.
February 03, 2020