[Hiring] Provider Relations Rep - ACO @UHS

Role Description

The ACO Provider Relations Representative is responsible for assisting in the full range of provider relations and service interactions for all lines of business within Prominence Health Plan.

• Assist in the design and implementation of programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers.
• Support those who direct and implement strategies relating to the development and management of a provider network.
• Identify gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs.
• Involved in identifying and remediating operational short-falls and researching and remediating claims.
• Responsible for steerage initiatives, site visits, training, educating, and overall communications including portals, webpages, letters, and email messages.
• Oversee and manage Medicare Quality Reporting during each performance year and through the annual reporting periods.
• Ensure resources are in place to complete the annual GPRO reporting requirement.

*This position is remote and work from home with travel around Amarillo and Lubbock, TX.

Qualifications

• BS in Business Administration, Finance or similar field, or equivalent work history.
• 2+ years in HEDIS, ACO, or Care Gap reporting.
• 2+ years working with Medicare contracts and regulatory reporting requirements.
• 3 years in managed care or medical insurance.
• 2 years working in a clinical setting.
• 1 year in a claims, customer service or provider support role.
• Excellent oral and written English communication skills including telephone etiquette.
• Superior interpersonal skills.
• Proficient research, critical-thinking and analytical problem-solving skills.
• Intermediate proficiency with Microsoft Office (Excel, Word, PowerPoint, Outlook).
• Self-starter and resourceful with ability to execute projects in a fluid and fast-paced environment.
• Strong organizational, planning and attention to detail skills.
• Valid Driver’s License, reliable transportation, and proof of insurance required.
• Requires local travel and occasional out of area overnight travel.

Benefits

• Loan Forgiveness Program.
• Challenging and rewarding work environment.
• Competitive Compensation & Generous Paid Time Off.
• Excellent Medical, Dental, Vision and Prescription Drug Plans.
• 401(K) with company match and discounted stock plan.
• SoFi Student Loan Refinancing Program.
• Career development opportunities within UHS and its 300+ Subsidiaries.

Company Description

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance.

• Recognized as one of the World’s Most Admired Companies by Fortune.
• Listed in Forbes ranking of America’s Largest Public Companies.
• Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S., Washington, D.C., Puerto Rico and the United Kingdom.