SUMMARY: The Provider Relations Specialist is responsible for providing exceptional service to the Avera Health Plans delivery network. The Provider Relations Specialist is responsible for the expansion of the Avera Health Plans network and the building of new networks that support the delivery of new products and services. In doing so, the Provider Relations Specialist demonstrates exceptional negotiation and problem solving skills. The Provider Relations Specialist researches and resolves specific provider issues and educates providers on health plan policies and procedures. The Provider Relations Specialist builds positive business relationships and assures compliance with contractual terms and conditions. The Provider Relations Specialist recommends and creates opportunities for enhancing Avera Health Plans relationship with providers and improving the overall productivity and efficiency of the Provider Relations functions.
REQUIRED EDUCATION and/or EXPERIENCE:
· Bachelor’s degree in Health Administration, Business, or related field.
· Relevant work experience demonstrating an understanding the principles of healthcare delivery and finance.
· Relevant work experience demonstrating an understanding of business re l ationship management and negotiation skills.
REQUIRED CERTIFICATION, LICENSURE, and/or REGISTRATIONS:
· This position requires a valid driver’s license and that the employee is insurable by the Avera Health automobile liability insurance carrier.
Avera Health - 23 months ago