Provider Relations Representative - Lewis County
Fidelis Care - Syracuse, NY

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5010 Campuswood Dr. Syracuse, NY 13057

Provider Relations

BA/BS Degree

Two - four years of healthcare or managed care experience required; previous provider relations/services experience strongly preferred.

Strong verbal and written communications skills; strong computer skills, as well as the ability to multitask are necessary. Drivers license and car required.

Ensures the provision of the highest level of service to Fidelis Care New York providers. Assure that all provider orientations, site visits, access and availability studies are completed within designated timeframes. Assure that all providers are visited within established timeframes. Complete credentialing and re-credentialing audits for delegated providers. Foster strong, positive, collaborative relationships with key providers by coordinating, facilitating and leading partnerships meetings and identifying onsite enrollment opportunities for Marketing. Investigate and resolve provider complaints and member complaints regarding providers to maintain member and provider satisfaction. Proactively identify provider needs and advise management so that action can be taken to address the needs before they are problematic for the provider. Educate providers on the Fidelis/CenterCare provider incentive programs. Facilitate retrieval Fidelis/CenterCare member healthcare records to ensure achievement of optimum QARR scores. Investigate and coordinate resolution to claims payment issues. Assist Contract Management in identification of network deficiencies and make recommendations on how to address them.

This position will be focused in Lewis County.

About this company
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From humble beginnings in a 14-zip code area of Brooklyn in 1993, to presence in all 62 counties of New York State today, Fidelis Care's...