Provider Relations Representative, Sr. jobs in Farmington, MI

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)

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Provider Relations Specialist - Marquette, Michigan (Hybrid)
  • Homeward Health
  • Detroit, MI FULL_TIME
  • Homeward is a technology-enabled healthcare provider delivering quality, affordable and comprehensive care to those who don't have it. Starting in rural America. Today, 60 million Americans living in rural communities are facing a crisis of access to care. In the U.S. healthcare system, rural Americans experience significantly poorer clinical outcomes. This trend is rapidly accelerating as rural hospitals close and physician shortages increase, exacerbating health disparities. In fact, Americans living in rural communities suffer a mortality rate 23 percent higher than those in urban communities, in part because of the lack of access to quality care.

    Our vision is care that enables everyone to achieve their best health. So, we're rearchitecting the way it's delivered - leveraging breakthroughs in diagnostics, remote monitoring, and a variety of other domains, Homeward is creating a new healthcare delivery model that is purpose-built for rural America and directly addresses the issues that have historically limited access and quality.

    Most importantly, we're aligning everyone's incentives (ours, partner health plans', and members') towards getting and keeping people healthy by taking full responsibility and financial risk for the total cost of each member's healthcare and outcomes.

    Homeward is co-founded by a leadership team that defined and delivered Livongo's products, and backed most recently by a $50 million series B co-led by Arch Ventures and Human Capital, with participation from General Catalyst for a total of $70 million in funding. With this leadership team and funding, Homeward is committed to bringing high-quality healthcare to rural communities in need.


    The Opportunity

    We are seeking a highly motivated Provider Relations Specialist responsible for field activities that educate and support providers in the Homeward service area in the Upper Peninsula of Michigan regions. 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 Michigan 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 Michigan 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, training materials, 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 the 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.

     

  • 8 Days Ago

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Provider Relations Specialist - Michigan Market (Hybrid)
  • Homeward Health
  • Detroit, MI FULL_TIME
  • Homeward is a technology-enabled healthcare provider delivering quality, affordable and comprehensive care to those who don't have it. Starting in rural America. Today, 60 million Americans living in ...
  • 16 Days Ago

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Labor Relations Representative Analyst
  • Cleveland Cliffs
  • Dearborn, MI FULL_TIME
  • Cleveland-Cliffs is seeking a dynamic candidate to join the Labor Relations team at our Dearborn Works location. A Labor Relations Representative administers the terms of the Collective Bargaining Agr...
  • 21 Days Ago

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Labor Relations Representative Analyst
  • Cleveland-Cliffs Steel Corporation
  • Dearborn, MI FULL_TIME
  • Cleveland-Cliffs is seeking a dynamic candidate to join the Labor Relations team at our Dearborn Works location. A Labor Relations Representative administers the terms of the Collective Bargaining Agr...
  • 21 Days Ago

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Advanced Practice Provider
  • LTC Provider Care
  • Detroit, MI FULL_TIME
  • LTC Physician Care, PC is a new and emerging medical group dedicated to serving patients in the Skilled Nursing and Long-Term Care facility settings. Our goal is to improve the overall quality of care...
  • 18 Days Ago

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Advanced Practice Provider - SNF/LTC
  • LTC Provider Care
  • Clinton, MI FULL_TIME
  • LTC Physician Care, PC is a new and emerging medical group dedicated to serving patients in the Skilled Nursing and Long-Term Care facility settings. Our goal is to improve the overall quality of care...
  • 18 Days Ago

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0 Provider Relations Representative, Sr. jobs found in Farmington, MI area

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Parts Advisor
  • Jaguar Land Rover Novi
  • Novi, MI
  • Fox Motors has a Parts Advisor opening in Novi, MI at Jaguar Novi. You would contribute to our overall vision, "Working ...
  • 3/28/2024 12:00:00 AM

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FT Customer Service Representative - Work From Home>
  • Dick's Sporting Goods, Inc.
  • Farmington, MI
  • [Customer Support / Remote] - Anywhere in U.S. / Up to $46.2K per year / Benefits - As a Customer Service Rep you'll: As...
  • 3/27/2024 12:00:00 AM

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Customer Service Representative
  • Gasserbush
  • Livonia, MI
  • **Customer Service Representative** Customer Service Livonia, Michigan Department **Customer Service** Minimum Experienc...
  • 3/27/2024 12:00:00 AM

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Customer Service / Inside Sales Representative
  • Quality Choice | CDMA
  • Novi, MI
  • Job Description Job Description Headquartered in Novi, Michigan, Quality Choice|CDMA, which spans almost a century, is a...
  • 3/27/2024 12:00:00 AM

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FT Customer Service Representative - Work From Home>
  • Dick's Sporting Goods, Inc.
  • Redford, MI
  • [Customer Support / Remote] - Anywhere in U.S. / Up to $46.2K per year / Benefits - As a Customer Service Rep you'll: As...
  • 3/26/2024 12:00:00 AM

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Customer Service Representative
  • Berkshire Production Supply
  • Novi, MI
  • Job Description Berkshire eSupply is a dynamic organization dedicated to supporting independent distributors with the pr...
  • 3/26/2024 12:00:00 AM

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Customer Service Representative
  • Reliance One, Inc.
  • Novi, MI
  • Job Requirements The Customer Service Representative works within the customer support team to provide support our Produ...
  • 3/25/2024 12:00:00 AM

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Patient Services Representative
  • Midwest Vision Partners
  • Southfield, MI
  • Patient Services Representative Department: Clinical Operations Employment Type: Full Time Location: Southfield Office R...
  • 3/24/2024 12:00:00 AM

Farmington is a city in Oakland County of the U.S. state of Michigan. It is one of the northern suburbs of Detroit. As of the 2010 census, the city population was 10,372. It is surrounded by Farmington Hills, except for a small portion bordered by Livonia to the south. Since 2009, the city's downtown has been the center of an extensive renovation and remodeling featuring a refacing or rebuilding of many buildings on Grand River Avenue, as well as brick paver sidewalks, the Farmington Pavilion, new lighting, and landscaping. The area is known for its historic downtown, elegant Victorian-style h...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Relations Representative, Sr. jobs
$71,844 to $89,096
Farmington, Michigan area prices
were up 1.2% 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.
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Provides telephonic provider education to new providers.
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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