Job Information
Highmark Health Manager Provider Relations in Charleston, West Virginia
Company :
Highmark Inc.
Job Description :
JOB SUMMARY
This job manages a team of provider relations’ representatives and staff to provide high quality service to providers participating in the organization’s network. The incumbent motivates a team through the creation of a work environment that fosters a service-driven approach. The incumbent is accountable for developing positive and strategic relationships with providers and community partners and serves as the point of contact for the department.
You must be a West Virginia resident for this role and the position is hybrid - 3 days a week in the office
ESSENTIAL RESPONSIBILITIES
Manage team of provider relations representatives and support staff in servicing health systems and large providers.
Provide information to management regarding identified procedural, operational and contractual improvements.
Provide daily oversight of staff responsible for updating and maintaining practice files in applicable systems and providing timely dissemination of practice changes to the appropriate departments.
Support internal customer requests.
Work closely with other areas to resolve provider service and contracting issues.
Represent the department in workgroups and committees that address both internal and external customer concerns.
Oversee and coordinate all training and mentoring activities for new and existing departmental staff.
Other duties as assigned or requested.
EXPERIENCE
Required
5 years in the Healthcare or Insurance industry
3 years in a management or leadership role
Preferred
- Experience with claims processing and coding
SKILLS
Experience with customer relationship management
Strong organizational, analytical and interpersonal skills
Very good leadership skills
Excellent verbal and writing skills
Working knowledge of the pertinent state(s) Medicaid Managed Care contract and managed care in general
Experience with conflict resolution
Working knowledge of various payment algorithms and methodologies
Ability to act as a change agent
EDUCATION
Minimum
- Bachelor’s degree or 6 years of related and progressive experience lieu of Bachelor's Degree
Preferred
- Master’s degree
LICENSES or CERTIFICATIONS
Required
- None
Preferred
- None
Language (Other than English):
None
Travel Requirement:
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office- or Remote-based
Teaches / trains others
Occasionally
Travel from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
No
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Rarely
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Pay Range Minimum:
$67,500.00
Pay Range Maximum:
$124,800.00
Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf )
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J241068
Highmark Health
- Highmark Health Jobs