Lead Provider Relations Representative

Providence Health & Services
life insurance, parental leave, 401(k)
United States, Oregon, Portland
Dec 12, 2024
Description Under the supervision of the Senior Manager Provider Relations, this position is responsible for physician recruitment related activities and building relationships with Providence contracted physicians/specialist offices. Key responsibilities include Physician office in-services, continuous physician office education, fielding questions, researching and resolving inquiries, identifying issues, management and dissemination of network communications, identifying and vetting new PCP contract opportunities, and overall network performance. This position works with leadership to develop action plan for specific metrics/providers needing improvement, identifies PCP & SPC network gaps, and manages network performance meeting agenda and follow-ups. Activities of this role can impact the open enrollment period, and submission of documentation and recuperation of coding to improve Risk Adjusted Factors (RAF) scores. Providence caregivers are not simply valued - they're invaluable. Join our team at Providence Medical Foundation and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Required Qualifications: Upon request: Driving may be necessary as part of this role. Caregivers are required to comply with all state laws and requirements for driving. Caregivers will be expected to provide proof of driver license and auto insurance upon request. See policy for additional information. 5 years experience in a Provider Relations role working with physicians in Affiliate/IPA, with a minimum 2 of these years at a Senior level Provider Relations role. 5 years Managed care Provider Relations experience. Preferred Qualifications: Bachelor's Degree in Healthcare Management or related field. Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. About Providence At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits. About the Team Providence Clinical Network (PCN) is a service line within Providence serving patients across seven states with quality, compassionate, coordinated care. Collectively, our medical groups and affiliate practices are the third largest group in the country with over 11,000 providers, 900 clinics and 30,000 caregivers. PCN is comprised of Providence Medical Group in Alaska, Washington, Montana and Oregon; Swedish Medical Group in Washington's greater Puget Sound area, Pacific Medical Centers in western Washington; Kadlec in southeast Washington; Providence's St. John's Medical Foundation in Southern California; Providence Medical Institute in Southern California; Providence Facey Medical Foundation in Southern California; Providence Medical Foundation in Northern and Southern California; and Covenant Medical Group and Covenant Health Partners in west Texas and eastern New Mexico. Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. Requsition ID: 328857 Company: Providence Jobs Job Category: Provider Network Job Function: Health Plans Services Job Schedule: Full time Job Shift: Day Career Track: Business Professional Department: 7520 PROVIDER RELATIONS CA HERITAGE SERVICES Address: CA Anaheim 200 W Center St Promenade Work Location: St Joseph Home Health-Anaheim Workplace Type: On-site Pay Range: $32.40 - $51.29 The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.