Provider Relations Representative I
- Professional, ethical and respectable representation of Kern Health Systems to the Provider community.
- Work directly with providers and staff to develop and facilitate efficient health care delivery network, resolve issues, and provide continued provider support.
- Work as both provider advocate and plan representative; answering questions, identifying and evaluating problems, communicating resolutions in a timely manner.
- Under supervision/direction of Supervisor, negotiates and maintains effective and efficient systems and procedures for recruiting, and contracting with a full range of health care providers.
- Assists with conducting individual/group provider orientation sessions and follow-up orientations with both prospective provider groups and participating physicians.
- Assists with developing, updating and disseminating a provider administrative manual to ensure that providers and their administrative staff have up-to-date plan information and are familiar with the KFHC policies, procedures and operations.
- Types provider related and departmental correspondence.
- Conducts periodic provider satisfaction surveys and reports results to supervisor.
- Possess, and demonstrate full understanding of the various provider contracts maintained by KHS.
- Responsible for maintaining and documenting all types of provider contacts in provider files.
- Assists with analyzing various reports to monitor provider activity and to identify provider problems. This may include assisting with developing and implementing necessary action plans.
- Utilizes personal computer for tracking detailed data, performing data analysis, generating reports, documentation and project evaluation purposes.
- Assists in the development and preparation of various state required reports, which may include network analysis, statistical preparation and mapping skills.
- Possess working knowledge of KHS Policies and Procedures. Other Functions
- Assists management staff in completing provider relations related projects as assigned.
- Interfaces with other departments in the development, preparation and distribution of provider and/member satisfaction surveys.
- Performs other job related duties as assigned.
- Travel independently to conduct provider visits with own reliable transportation.
- Adheres to all company policies and procedures relative to employment and job responsibilities.
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