Provider Relations Representative

Plays a key role in supporting our VNS Health Upstate Network. Assists with building relationships with providers, assisting with operational tasks (such as credentialing and claims), and coordinating the implementation of performance improvement strategies. Works closely with existing and potential providers to ensure their satisfaction. This position operates under general supervision.

• Referral bonus opportunities
• Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
• Employer-matched retirement saving funds
• Personal and financial wellness programs
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
• Generous tuition reimbursement for qualifying degrees
• Opportunities for professional growth and career advancement
• Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities

• Assists with creating provider contracts and contract amendments, including recruitment, contracting (Negotiates contractual terms, services and rates of reimbursement), credentialing, recredentialing and relationship maintenance through regular visits and ongoing contact with existing and potential providers.
• Prepares materials for providers and assist with understanding contract terms, program requirements, and service coordination.
• Supports the positive provider relationships with provider community by regular on-site and/or virtual/digital visits, communicating administrative and programmatic changes, and facilitating education and the resolution of provider issues.
• Coordinates provider site visits.
• Coordinates meetings to serve as a resource and addresses provider issues. Updates and maintains provider manuals with current Health Plan policies and procedures. Updates and proofs provider directories.
• Participates in special projects and performs other duties as assigned.

Education:

Bachelor's Degree in Business or equivalent related work experience, preferably in health care setting required

Work Experience:

Minimum one year of health care experience required. Prior experience in Provider Relations and contracting preferred. Knowledge of government programs, including Medicare and Medicaid preferred

USD $66,300.00 - USD $79,800.00 /Yr.

VNS Health has been committed to meeting the needs of New Yorkers for over 130 years. We’re one of the largest nonprofit home- and community-based health care organizations in the country, and today, more than 11,500 team members work together to make a difference in the lives of more than 99,000 patients and members on any given day.