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Provider Relations Specialist

Job in Sacramento - Sacramento County - CA California - USA
Full Time position
Listed on 2019-08-27
Job specializations:
  • Healthcare
    Provider Enrollment, Home Care Provider
  • Marketing/PR
    Marketing Strategy
Job Description & How to Apply Below
Job Summary:

The Provider Relations Specialist will work for our Accountable Care Organization as the main point of contact for our providers and provider network. As a provider relations specialist, you will need to investigate and resolve provider issues whilst helping to expand knowledge of our services. You are also responsible for answering questions from health care providers about service contracts, in-network services available and billing.


Educates providers on protocols, policies, procedures, portals and services to improve overall provider experience
Maintain a positive, professional, and amenable relationship with the provider network
Escalates issues as appropriate
Perform duties as a liaison between providers, Corporate and the ACO Organization
Serve as a primary contact for providers serving as a liaison between the provider and the health plan
Receive and respond to external provider related issues
Resolve, investigate and communicate provider claim issues and changes
Initiate entry or change of provider related database information
Author change requests and oversee through testing and completion
Conduct regular meetings and check ins with providers documenting discussions, issues, attendees, and action items researching claims issues on-site and routing to the appropriate party for resolution
Position Requirements
Bachelor,   3 to 4 Years work experience

Bachelor’s degree in Healthcare related field preferred
Strong verbal and written communication and interpersonal skills
Located or willing to relocate to Sacramento, CA
3+ years of marketing, provider relations or contracting experience
Knowledge of health care, managed care, Medicaid or Medicare
Experience with Customer Relationship Management tools
Previous experience with an Accountable Care Organization is highly preferred
Required Language Skills:
  • English - Very good
Questions to answer on applying for this job
  • Years of Marketing, Provider Relations or Contracting Experience:
  • Years of experience with an Account Care Organization:
  • Are you located in Sacramento, CA?
  • Are you authorized to work in United States?
Contact Information
Contact Name: Achiever ACO (Look for LYN)
Contact Phone: 916-518-9433 ext 555
Preferred method of contact: Email with CV via Application Box below.
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