Provider Relations Representative, Sr. jobs in Somerset, NJ

Job Summary:

The Provider Relations Rep will be responsible for developing and maintaining relationships with physician and business leadership of key physician groups. The Provider Relations Rep will oversee and monitor all provider activities which includes: ensuring network accessibility thresholds are met, securing contracts, amendments and single case agreements as needed, managing the provider termination process and other related duties which impact the overall network.

Essential Functions:

• Communicates with external constituents and effectively engages the provider community, demonstrating the organization s value proposition
• Manage a database of potential providers for recruitment; gather necessary data and relevant information to present to management for effective contract negotiations maintain an effective tracking system of all outreach attempts, communications and final outcomes
• Consistently monitors organization s service capabilities to collaboratively ensure that provider and members needs are met
• Assists with physician recruitment into RWJ Value based programs
• Manages all provider data submission for RWJ value based programs
• Resolves first line policy questions referred by practice staff and works with partner managers as needed to resolve escalated issues
• Contributes to development and maintenance of member and provider materials
• Works collaboratively with partner departments, information technology and facility based programs to provide seamless customer service to providers
• Communicates and escalates provider issues as needed in real time to appropriate partner departments and/or seniors management
• Participates as a representative of Network Management Administration team on internal committees and workgroups, as assigned
• Contributes to the Network Management Administration team effort by accomplishing related tasks and projects as needed
• Produces various presentation and marketing materials for various physician recruitment and direct-employee strategy
• Maintains RWJBH Medical Neighborhood operationally and audit physician s demographic information who are participating in Medical Neighborhood to ensure data accuracy
• Assists with any other projects for the network management department as required

Job Requirements:

• Associate Degree or higher required
• 1-3 years of healthcare experience
• Must possess strong interpersonal, communication, management, and technology skills.
• Must demonstrate team building and collaborative practice behaviors
• Must demonstrate understanding of performance improvement and quality outcomes management
• Physician office operations experience
• Ability to travel various part of New Jersey to visit the Physician/Physician Groups
• Demonstrate ability to multi-task, prioritize, and use good judgement in a fast-paced environment
• Strong presentation and problem-solving skills; familiar with root cause analysis.

Other Duties:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

We offer a great work environment, competitive rates and excellent benefits, including:

• Medical/Dental/Vision plans
• 401 (k)
• Vacation/Personal/Holiday/Sick Time Off
• Short & Long Term Disability
• Basic Life & Accidental Death Insurance
• Tuition Reimbursement
• Health Care/Dependent Care Flexible Spending Accounts

RWJBarnabas Health is the most comprehensive health care delivery system in New Jersey and the state s second largest private employer with more than 32,000 employees, 9,000 physicians and 1,000 residents and interns. The system includes eleven acute care hospitals, three acute care children s hospitals and a leading pediatric rehabilitation hospital (Children s Specialized Hospital).