Provider Relations Representative, Sr. jobs in Bedford, NH

Responsibilities:

The Senior Communications Specialist is responsible for all communication tasks that impact either internal or external customers from the provider perspective: coordination of all written and on-line communications to physicians, hospitals, and ancillary providers.  Responsible for the development of communications and materials about provider and member education programs that increase the effectiveness of providers’ and members’ compliance with Plan rules and requirements.  

In conjunction with Provider Network Management Communications Director assists in developing and, communicating strategies to engage contracted providers’ office managers/staff in training sessions held throughout the service area,   Coordinates info from SME’s and prepares educational tools for Account Executives use in educating contracted and non-contracted providers. 

Coordinates and develops and implements production and posting of PLAN resources such as provider manual, Plan E-Business Technology, web site development and maintenance, and fee schedules, etc.

Interfaces with Plan’s data analyst to compile, analyze, and disseminate information from provider calls, reports, and trends.

Collaborates with care management team regarding implementation of products and communications related to improved health status of our members, achieving NCQA accreditation, HEDIS measures, etc.

Education/Experience:

• Bachelor Degree in Communications, English, or Marketing or equivalent combination of education and work experience in a Health Care Field preferred.
• 1 to 2 years leadership and project management experience in member and/or provider operations in a healthcare or Managed Care Organization to include experience in training and communication material development similar to this job’s content.
• 1 to 2 years Medicaid experience preferred.
• Valid Driver’s License.
• Current Auto Insurance.