Provider Consultant - Broward County, FL

Provider Consultant - Broward County, FL

Base pay range
$65,000.00/yr - $80,000.00/yr

This position is responsible for the following:

• Serve as the primary liaison between The Healthcare Network and the participating provider community who service our members in multiple product lines throughout the network.
• Build and maintain strong relationships with providers by offering excellent customer service to assigned primary care and specialty care physicians with routine and targeted education visits for continued education regarding policies/initiatives. Service also includes supply deliveries and prompt follow‑up regarding claims, benefits and procedural guidelines for authorization of services.
• Conduct on‑site visits, telephonic conversations and written communications with individuals including Hospital executives, Patient Account Managers, Physicians, Office and Billing Managers.
• Perform on‑site provider orientations and group county orientations for new primary care and specialty care physicians regarding policies, procedures, billing and company‑wide initiatives.
• Represent the Provider Consultant Department in work groups and committees that address both internal and external customer concerns regarding the operations of The Healthcare Network as it pertains to the provider community.
• Other duties as assigned.
• Applicant must be highly proficient and creative at identifying and solving problems.

Incumbent must be able to work independently as a telecommuter and attend off‑site meetings, including overnight stays.

• Communicate effectively as a liaison between the provider community and PBACO to provide education on policies and procedures and assist in the resolution of issues or concerns a provider may have.
• Perform on‑site provider orientations for primary care and specialty care physicians regarding policies, procedures, billing and company‑wide initiatives within 30 days of becoming credentialed and approved.
• Oversee group county provider orientations by determining location, arranging for mailing of invitations and making PBACO provider forms, QI Manuals, directories and the PBACO Provider Office Policy and Procedure Manual available at the presentation, as needed.
• Conduct annual Goal/Target visits for primary care and specialty care physicians within a specific geographic territory to provide continued education regarding policies/initiatives. Each Provider Consultant will schedule minimally one goal visit per year with participating practices in the following specialties:
  Primary Care / Specialists.

• 2 years’ experience in Provider Relations and/or Managed Care Product Administration.
• Valid unrestricted driver’s license.

• Bachelor’s degree in Business Administration, Marketing, Health Care Administration or another related degree.
• 2 years’ Provider Relations experience or medical office or hospital experience.
• 2 years’ exposure to medical claims processing procedures.
• Knowledge and understanding of the dynamics of the Managed Care environment, including capitation and reimbursement structure.

The position requires driving for extended periods of time and walking to and from provider offices, potentially up and down stairs.

Entry level

Full‑time

Consulting, Information Technology, and Sales

Hospitals and Health Care