VNS Health
Provider Relations Representative
VNS Health, New York, New York, us, 10261
OverviewManages all aspects of provider relations within a specified geographic region. Regularly visits and maintains ongoing contact with existing/potential providers for relationship building, recruitment, credentialing, re-credentialing and assisting with provider issues and education. Works under general supervision.
Compensation:$30.71 - $38.41 HourlyWhat We ProvideReferral bonus opportunitiesGenerous paid time off (PTO), starting at
20 days
of paid time off and 9 company holidaysHealth insurance plan for you and your loved ones, including Medical, Dental, Vision, Life and DisabilityEmployer-matched retirement saving fundsPersonal and financial wellness programsPre-tax flexible spending accounts (FSAs) for healthcare and dependent careGenerous tuition reimbursement for qualifying degreesOpportunities for professional growth and career advancementInternal mobility, generous tuition reimbursement, CEU credits, and advancement opportunitiesInterdisciplinary network of colleagues through the VNS Health Social Services Community of ProfessionalsWhat You Will DoManages all provider contracts in designated territory, including recruitment, credentialing, recredentialing and relationship maintenance through regular visits and ongoing contact with existing and potential providers.Prepares materials for and orients providers to contract terms and operating requirements, Health Plan program and eligibility requirements, and service coordination.Collaborates with the Network Development and Contracting and Service Operations departments to administer demographic changes and renewals to provider contracts.Monitors contract performance of network providers and serves as a liaison between the Health Plan and the Provider to ensure the flow of information regarding resolution of member service issues.Coordinates provider site visits, as needed.Coordinates and attends meetings to serve as a resource and address provider issues.Updates and maintains provider manuals with current Health Plan policies and procedures.Updates and proofs provider directories.Assists providers in triaging billing and claims disputes.Participates and collaborates with Compliance on Department of Health and internal audits.Participates in special projects and performs other duties as assigned.
QualificationsLicenses and Certifications:Driver's license, requiredEducation:Bachelor's Degree or equivalent related work experience, preferably in health care setting, requiredWork Experience:Minimum three years health care experience, requiredKnowledge of government programs, including Medicare and Medicaid, preferredPrior experience in Provider Relations, preferredReliable transportation to work sites, required
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Compensation:$30.71 - $38.41 HourlyWhat We ProvideReferral bonus opportunitiesGenerous paid time off (PTO), starting at
20 days
of paid time off and 9 company holidaysHealth insurance plan for you and your loved ones, including Medical, Dental, Vision, Life and DisabilityEmployer-matched retirement saving fundsPersonal and financial wellness programsPre-tax flexible spending accounts (FSAs) for healthcare and dependent careGenerous tuition reimbursement for qualifying degreesOpportunities for professional growth and career advancementInternal mobility, generous tuition reimbursement, CEU credits, and advancement opportunitiesInterdisciplinary network of colleagues through the VNS Health Social Services Community of ProfessionalsWhat You Will DoManages all provider contracts in designated territory, including recruitment, credentialing, recredentialing and relationship maintenance through regular visits and ongoing contact with existing and potential providers.Prepares materials for and orients providers to contract terms and operating requirements, Health Plan program and eligibility requirements, and service coordination.Collaborates with the Network Development and Contracting and Service Operations departments to administer demographic changes and renewals to provider contracts.Monitors contract performance of network providers and serves as a liaison between the Health Plan and the Provider to ensure the flow of information regarding resolution of member service issues.Coordinates provider site visits, as needed.Coordinates and attends meetings to serve as a resource and address provider issues.Updates and maintains provider manuals with current Health Plan policies and procedures.Updates and proofs provider directories.Assists providers in triaging billing and claims disputes.Participates and collaborates with Compliance on Department of Health and internal audits.Participates in special projects and performs other duties as assigned.
QualificationsLicenses and Certifications:Driver's license, requiredEducation:Bachelor's Degree or equivalent related work experience, preferably in health care setting, requiredWork Experience:Minimum three years health care experience, requiredKnowledge of government programs, including Medicare and Medicaid, preferredPrior experience in Provider Relations, preferredReliable transportation to work sites, required
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