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Provider Relations Specialist

Company: Bright Health
Location: Knoxville
Posted on: June 12, 2021

Job Description:

"Making Healthcare Right. Together." is the cornerstone of all we do. Our vision is through powerful relationships with Care Partners, we help all people live healthy and brighter lives. To successfully achieve our mission and vision as we operate in a dynamic health care environment, we expect Bright employees to embody and uphold our core values in work and interactions, both internal and external: be brave, be brilliant, be accountable, be inclusive, and be collaborative.

ABOUT THE ROLE

Our Integrated Delivery Development team is responsible for partnering with our Care Partners to turn their provider networks into market leading integrated delivery systems. We are reimagining how the network development, network management, and provider relations functions can advance affordable, simple, and personal care for our members. As our Provider Relations Representative, you will manage the flow of all current and future provider communications, service, issue resolution, and data management to and from our Care Partner and other providers in the market to build the foundation for a strong connection between Bright and our provider partners.

YOUR RESPONISIBILITIES

  • Provider Account Management
  • Ongoing, professional, and effective touchpoints with all active providers in Bright's network
  • Relationship manager for Care Partner provider relations' staff
  • Provide high level of customer service
  • Build provider awareness of and engagement with Bright Health

Provider Education and Network Management

Proactive research and resolution of provider issues including but not limited to claims submission, processing, and payment; contracting details; provider tools; and UM and other protocolsEnsure accurate ongoing collection of key provider data element updates and changes Supporting providers through the credentialing/re-credentialing process, including addressing provider questions, ensuring timely completion of applications, and supporting the Bright Health credentialing teamHold education sessions for providers to ensure alignment and understanding of Bright HealthCollaborate with Care Partner Provider Relations staff in the creation and distribution of orientation and educational materials to all levels of personnel within a hospital, ancillary services or physician office setting

Provider Development and Contracting

Proactive identification and closure of network gaps as well as development of performance reports Lead negotiation and execution of additions and renewals of provider contracts to ensure network adequacyOwn maintenance of contract management system for assigned provider contracts

Cross-functional Bright support

Serve as internal Bright Health provider advocate by communicating key provider pain points and working with key stakeholders to advance our support of our contracted providersCollaborate with Marketing, Sales, Provider Data, Credentialing, Operations, HOT, and other teams to coordinate cross-functional in-market activities.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

  • High School Diploma or GED required; Bachelor's degree in Business, Health Care Administration, Communications or a related field is preferred; equivalent work experience and education will be considered in lieu of a degree
  • Three (3) or more years of experience in the healthcare industry navigating relationships around providers and insurance networks is preferred

ABOUT US

At Bright Health, we brought together the brightest minds from the health care industry and consumer technology, and together we created Bright Health: a new, brighter approach to healthcare, built for individuals. Our plans are easy to manage, personalized, and more affordable, giving people the quality care they deserve. Through our exclusive care partnerships with leading health systems in local communities, we are reshaping how people and physicians achieve better health together.

We're Making Healthcare Right. Together.

We've won some fun awards like Modern Healthcare and Forbes, etc. But more than anything, we're a group of people who are really dedicated to our mission in healthcare. Come join our team!

As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

BRIGHT ON!

Keywords: Bright Health, Knoxville , Provider Relations Specialist, Other , Knoxville, Tennessee

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