Provider Relations Representative, Sr. jobs in Tallahassee, FL

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)

Recently Added Provider Relations Representative, Sr. jobs

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Healthcare Network Development / Provider Relations Representative
  • Alivi
  • Tallahassee, FL FULL_TIME
  • SUMMARY
    The Network Development Representative focuses on building Specialty Benefits Networks across multiple Markets/States considering cost negotiations and adequacy to support expected membership volume by Levels of Service. The position will support the Specialty Benefits Networks with growth objectives and analytical analysis to ensure company strategies for expansion are adequate to meet contract demands for each respective Market/State. The position coordinates with Provider Leads to complete contracting with identified Specialty Benefit providers. 
    DUTIES & RESPONSIBILITIES
    • Target potential providers to establish contractual agreements.
    • Thoroughly understand Alivi’s Corporate Playbook and always ensure alignment with the     playbook in all day-to-day activities.
    • Work directly with strategic leaders of the company to ensure strategic support for expansion efforts and ability to administer contract arrangements with Health Plans/Payers in Medicare, Medicaid and Commercial lines of business. 
    • Travel to provider offices as needed to secure Specialty Benefit provider contracts.
    • Support Alivi’s business development, corporate growth strategy and goals as needed. 
    • Recruit, negotiate, contract and re-contract with Specialty Benefit providers at all ‘Levels of Service’ to ensure quality, cost effectiveness and their participation in all products.
    • Support contracting efforts for new products/risk strategies and help develop new service areas and negotiating with new providers.
    • Support in the development of strategic initiatives relating to provider networks, including service area expansions, new payment and incentive methods, risk arrangements and new products.
    • Work with provider relations team to develop and maintain a comprehensive provider network (hospitals, physicians, ancillary) that meets CMS access standards and deliver a full range of healthcare services to our members.
    • Analyze, plan, and assure provider network adequately meets all CMS access standards across all geographic areas.
    • Communicate internally and externally regarding all provider related issues. Participate in key committees throughout the organization.
    • Act as a liaison between Alivi and contracted health plans concerning all aspects of Specialty Benefit provider network participation. 
    • Supports Credentialing Department by assisting with the collection of physician credentials for newly contracted providers.
    REQUIREMENTS
    • Associates Degree preferred.
    • 1 to 2 years experience with Specialty Benefit providers and downstream provider contracting. 
    • Knowledge of provider reimbursement strategies for Managed Care, government products and commercial products.
    • Must have a valid driver’s license.    
    • Must be able to pass DMV record check.  
  • 6 Days Ago
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HH Registered Nurse
  • SR COMPANIES LLC
  • Tallahassee, FL OTHER
  • Job Details Job Location: First Senior Home Health - Tallahassee, FL Position Type: Per Diem Salary Range: Undisclosed Description DUTIES To provide nursing care, in accordance with the patient's plan...
  • 28 Days Ago
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Caregiver
  • Sr Companies Llc
  • Valdosta, GA FULL_TIME
  • Summary: Responsible for enhancing and improving the SRIM experience specifically in heartfelt care for our residents and their families. Demonstrates and promotes SRIM’s core value of the golden rule...
  • 1 Month Ago
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Customer Relations Representative - State Farm Agent Team Member (Customer Relations Focus)
  • Travis Pate - State Farm Agent
  • Valdosta, GA FULL_TIME
  • Position Overview Successful State Farm Agent is seeking a qualified professional to join their winning team for the role of Customer Relations Representative - State Farm Agent Team Member (Customer ...
  • 4 Days Ago
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Customer Relations Representative - State Farm Agent Team Member
  • Gayla Parks - State Farm Agent
  • Tallahassee, FL 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...
  • 10 Days Ago
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Customer Relations Representative - State Farm Agent Team Member
  • Mike Frantz - State Farm Agent
  • Tallahassee, FL 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
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0 Provider Relations Representative, Sr. jobs found in Tallahassee, FL area

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Remote Customer Service Representative
  • Afni, Inc.
  • Tallahassee, FL
  • Description Starting Wage is $14.50 per hour + bonus. Our top agents earn an extra $4 with their bonus! To learn more ab...
  • 4/15/2024 12:00:00 AM
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Customer Service Representative - SPANISH Bilingual - Remote - Work from Home
  • Smi Inc
  • Tallahassee, FL
  • ** Customer Service Representative - SPANISH Bilingual - Remote - Work from Home** **Job Category****:** Customer Servic...
  • 4/15/2024 12:00:00 AM
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Customer Service Representative - PART TIME - SPANISH Bilingual - Remote - Work from Home
  • Smi Inc
  • Tallahassee, FL
  • ** Customer Service Representative - PART TIME - SPANISH Bilingual - Remote - Work from Home** **Job Category****:** Cus...
  • 4/15/2024 12:00:00 AM
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Customer Service Representative
  • Smi Inc
  • Tallahassee, FL
  • ** Customer Service Representative** **Job Category****:** Customer Service **Requisition Number****:** CUSTO001954 Show...
  • 4/15/2024 12:00:00 AM
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Customer Service Representative - (Work From Home) BILINGUAL SPANISH
  • Smi Inc
  • Tallahassee, FL
  • ** Customer Service Representative - (Work From Home) BILINGUAL SPANISH** **Job Category****:** Customer Service **Requi...
  • 4/15/2024 12:00:00 AM
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Customer Service Representative - PART TIME - SPANISH Bilingual - Work from Home
  • Smi Inc
  • Tallahassee, FL
  • ** Customer Service Representative - PART TIME - SPANISH Bilingual - Work from Home** **Job Category****:** Customer Ser...
  • 4/15/2024 12:00:00 AM
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S
Patient Representative Coordinator
  • Sanitas
  • Tallahassee, FL
  • Job Details Level Entry Job Location Tallahassee - Apalachee - Tallahassee, FL Position Type Full Time Education Level H...
  • 4/14/2024 12:00:00 AM
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Customer Service Representative
  • Walmart
  • Tallahassee, FL
  • **Job Title: Customer Service Representative (Walmart)** **Job Summary:** As a Customer Service Representative at Walmar...
  • 4/14/2024 12:00:00 AM
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About Tallahassee, Florida

Tallahassee (/ˌtæləˈhæsi/) is the capital city of the U.S. state of Florida. It is the county seat and only incorporated municipality in Leon County. Tallahassee became the capital of Florida, then the Florida Territory, in 1824. In 2017, the population was 191,049, making it the 7th-largest city in the U.S state of Florida, and the 126th-largest city in the United States. The population of the Tallahassee metropolitan area was 382,627 as of 2017[update]. Tallahassee is the largest city in the Florida Panhandle region, and the main center for trade and agriculture in the Florida Big Bend and S...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Relations Representative, Sr. jobs
$64,442 to $79,916
Tallahassee, Florida area prices
were up 1.5% from a year ago
View detail

What does a Provider Relations Representative, Sr. do?

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