Provider Relations Representative (Medicare Advantage/Managed Medicaid)

Provider Relations – Network Development SpecialistRemoteAt Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple – we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders – internal and external – driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity and empower each other to illuminate our collective potential.Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!JOB SUMMARYYou can shine with us as a Provider Relations Specialist within our Government Programs Network Development team. This is a full-time (40 hours per week) remote position based in Texas. In this position you will visit Healthcare provider offices and provide education about the network programs and products. This position requires travel, which could require overnight stays and requires an active and valid Driver’s License. Up to 70% travel within a geographic service area/territory, primarily to meet with providers on a frequent basis, and at times with little advance notice.COMPENSATION The salary range for this position is $58,000-$62,000 annually. Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity. JOB ROLES AND RESPONSIBILITIES Meet with Healthcare Provider office staff providing education about Claritev programs and products. Cultivate and foster business relationships with contracted providers and their office administration staff. Distribute printed materials to Healthcare Provider office staff. Address and resolve Provider concerns and issues within established guidelines. Coordinate Provider education meetings (both in-person and virtual) as needed. Serve as an internal point of contact for network issue resolution originating from Customer Service calls and inquiries Track both the number and type of Provider visits and produce weekly visit report. Provide directions to providers, clients and members on processes as needed. Meet our quality, customer service, productivity and service level performance standards on a consistent basis REQUIREMENTS Minimum bachelor’s degree in related or applicable field, or HS Diploma (or GED) and four (4) years’ experience related to network development Minimum 1-year experience in provider relations and network development, or equivalent provider/payer experience, successfully working with healthcare providers Valid Driver’s License and access to dependable transportation Up to 70% travel within a geographic service area/territory, primarily to meet with providers on a frequent basis, and at times with little advance notice Knowledge of Healthcare office settings and Healthcare operations Strong oral, and written presentation skills and ability to interact with all levels of a provider organization Strong communication skills (written, verbal and listening), analytical, negotiation, business acumen, organization, strategic, multitasking and prioritization skills Ability to understand and explain government-sponsored payment methodologies Ability to research answers from multiple sources timely and effectively Ability to work efficiently in a fast-paced environment with competing priorities Ability to work from home effectively Ability to travel daily within geographic service area, as well as out of state travel to attend Claritev sponsored meetings, appropriate professional conferences or other business travel purposes. QualificationsREQUIREMENTS Minimum bachelor’s degree in related or applicable field, or HS Diploma (or GED) and four (4) years’ experience related to network development Minimum 1-year experience in provider relations and network development, or equivalent provider/payer experience, successfully working with healthcare providers Valid Driver’s License and access to dependable transportation Up to 70% travel within a geographic service area/territory, primarily to meet with providers on a frequent basis, and at times with little advance notice Knowledge of Healthcare office settings and Healthcare operations Strong oral, and written presentation skills and ability to interact with all levels of a provider organization Strong communication skills (written, verbal and listening), analytical, negotiation, business acumen, organization, strategic, multitasking and prioritization skills Ability to understand and explain government-sponsored payment methodologies Ability to research answers from multiple sources timely and effectively Ability to work efficiently in a fast-paced environment with competing priorities Ability to work from home effectively Ability to travel daily within geographic service area, as well as out of state travel to attend Claritev sponsored meetings, appropriate professional conferences or other business travel purposes. BENEFITS We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities. Your benefits will include: Medical, dental and vision coverage with low deductible & copay Life insurance Short and long-term disability Paid Parental Leave 401(k) + match Employee Stock Purchase Plan Generous Paid Time Off – accrued based on years of service WA Candidates: the accrual rate is 4.61 hours every other week for the first two years of tenure before increasing with additional years of service 10 paid company holidays Tuition reimbursement Flexible Spending Account Employee Assistance Program Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits. EEO STATEMENT Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. If you would like more information on your EEO rights under the law, please click here. APPLICATION DEADLINE We will generally accept applications for at least 5 calendar days from the posting date or as long as the job remains posted. #LI-KB1