Provider Services - Provider Relations Representative 115-2006
On-site · Oklahoma City, Oklahoma, United States
Job Summary
Provider Relations Representative serves as the external liaison between the health plan and its contracted providers, onboarding new providers and delivering education on policies, procedures, and clinical quality initiatives (e.g., Star ratings, HEDIS, care gaps). Responsibilities include leading onboarding and ongoing educational sessions, developing agendas and materials, conducting provider trainings, educating on policies and prior authorization, tracking engagement and performance metrics, developing provider toolkits, coordinating with quality teams, and supporting on-site provider visits with a focus on high-quality customer service and relationship-building.
Required Qualifications
- Bachelor's degree in healthcare administration, public health or related field required OR each year of work experience in a healthcare or managed care setting can be substituted for each year of college not completed.
- Two to three years of industry related experience in managed care, insurance, physician environment or related area.
- Familiarity with Medicare Advantage, quality improvement programs, Stars ratings and HEDIS.
- Possess strong oral and written communication skills; experience conducting provider trainings.
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