Evolent Health Provider Relations Representative in Pensacola, Florida
It’s Time For A Change…Your Future Evolves Here
Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to work each day. We believe in embracing new ideas, challenging ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.
Are we growing? Absolutely—56.7% in year-over-year revenue growth in 2016. Are we recognized? Definitely. We have been named one of “Becker’s 150 Great Places to Work in Healthcare” in 2016 and 2017, and one of the “50 Great Places to Work” in 2017 by Washingtonian, and our CEO was number one on Glassdoor’s 2015 Highest-Rated CEOs for Small and Medium Companies. If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission. Join a mission with a company behind it.
What You’ll Be Doing:
As a Provider Relations Representative, your initial job duties will include, but are not limited to the following:
The Provider Relations Representative provides training, education and guidance to network providers within the service delivery area. This job is 70% field-based and requires access to personal transportation.
Essential Duties and Responsibilities may include:
Cultivate and maintain collaborative relationships with network providers.
Ability to contract with PCP’s, specialists, and ancillary providers with no language or rate negotiations.
Conduct on-site visits. Tasks include orientation, training, and working with providers and staff to problem solve day-to-day issues and identify barriers.
Introduce and familiarize providers on all aspects of the provider manual related to services, benefits and provider requirements; care coordination and authorization protocols; claims filing; and the web portal;
Collaborate with network development to identify gaps in the network and access issues.
Ensures contract SLA’s are met on frequency of meetings with providers, after hours availability, panel requirements and EMR usage.
Resolve network provider inquires timely through email, CRM, joint operating committee meetings and provider visits.
Maintain provider data integrity through demographic updates, terminations, etc.
Serve as internal liaison with operational departments regarding provider service projects
Create reports, projects, and other duties, as appropriate
Monitor and trend provider issues documented through workflow, calls, emails, and other avenues
Perform other duties as deemed appropriate
The Experience You’ll Need (Required):
Bachelor's degree or equivalent years of service
2 years’ experience with provider relations, field experience strongly preferred
Working knowledge of Medicaid and/or government managed care products and terminology
Familiarity with Region providers and hospitals, preferred
Ability to build strong provider relationships
Strong organizational, multi-tasking and time-management skills
Experience with rapidly adapting to process changes
Requires strong competency with Microsoft Office (specifically Microsoft Excel)
Proven ability to work independently and as a team member
Good communication (written and oral), interpersonal, problem resolution and critical thinking skills
Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin.