Provider Relations Representative Job at MVP Health Care
Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds—tech people, numbers people, even
people people—working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference—it’s time to make a healthy career move to MVP!
There are some positions at MVP where your work may require an onsite or community component. When working in an MVP office and/or in the community on behalf of MVP, you must be fully vaccinated against COVID-19, and have received the first booster dose within one month of eligibility.
There are some positions at MVP where your work may require an onsite or community component. When working in an MVP office and/or in the community on behalf of MVP, you must be fully vaccinated against COVID-19, and have received the first booster dose within one month of eligibility.
This role represents MVP Health Care in a professional and ethical manner to underscore its corporate image and mission. Provides service to network providers directly in the provider’s offices. Provides focused, content laden visits to new and existing physicians and office staff and coordinates resolution of credentialing, claims and contractual issues. Maintains effective, positive, cooperative relationships with network providers with a goal of increasing their overall satisfaction with MVP.
Participates in recruitment of new providers to expand MVP’s provider base established and newly licensed/expansion areas through:
Participates in recruitment of new providers to expand MVP’s provider base established and newly licensed/expansion areas through:
- Network analysis to ensure that the MVP network meets all of the NYS and other requirements regarding network adequacy.
- Identification and solicitation of providers to include in network
- Works to remedy deficiencies in network in accordance with State and Federal requirements
- Initiates contract discussions, and works collaboratively with the Leader, Professional Relations in the event of non-standard contract requirements, including contract language and rates, lines of business and product types.
- Conducts sites visits as required by credentialing.
- Meets with providers, facilities, and/or their staff to market, orient, and educate regarding MVP policy, protocols, quality and other initiatives.
Professional, External PR knows, interprets, and follows guidelines of MVP policies and rules. Maintains and communicates in-depth and up-to-date knowledge of regional competition. Functions as a direct contact for providers with unresolved issues and follows them through to resolution, maintaining detailed documentation. Manages and presents both small and large group presentations independently, including preparing the logistics, agendas, written presentations, content, and evaluations. Actively participates in annual provider seminars and webinars, including preparing the logistics, agendas, verbal presentation, content and evaluations. Develops and maintains relationships with internal staff including but not limited to regional marketing, claims/operations, member/provider services, Health Management, Quality, Credentialing and Medicare Risk Adjustment team and support them with dissemination of curriculum materials. Acts as a provider liaison for National Network plan and works on complex claim resolution. Assists with Corporate projects as assigned. Performs other duties as assigned.
POSITION QUALIFICATIONS
Minimum Education:
BA/BS Degree in Health, Marketing, or Business Administration preferred or Associates Degree with equivalent combination of experience considered.
BA/BS Degree in Health, Marketing, or Business Administration preferred or Associates Degree with equivalent combination of experience considered.
Minimum Experience:
2-3 years’ experience in a health care field with demonstrated provider recruitment and/or service track record preferred.
2-3 years’ experience in a health care field with demonstrated provider recruitment and/or service track record preferred.
Required Skills:
- Excellent communication and interpersonal skills, including the ability to negotiate, interact face-to-face and over the telephone with customers.
- Demonstrated strong presentation and facilitation skills.
- Ability to effectively handle difficult interpersonal situations.
- Demonstrated strong written skills, including the ability to create letters and other communications to providers.
- Valid NYS driver’s license and access to reliable vehicle, willing to travel extensively throughout MVP’s service areas, with overnights as required.
- Strong analytical problem solving and strategic business planning skills.
- Strong computer skills (Word, Excel and PowerPoint or comparable software) required. Proficiency with Facets, Cactus and Macess within 6 months from date of hire.
- Understanding of health insurance reimbursement models.
- Neat, well-groomed, professional appearance with positive, enthusiastic attitude.
- Able to demonstrate strong relationship building skills.
About MVP
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for more than 700,000 members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse, employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve. MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the Know your Rights protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com
Please apply and learn more – including how you may become a proud member of our team.
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