A Provider Relations Representative facilitates the organizational goals with physicians as well as staff throughout MemorialCare Medical Foundation. In collaboration with internal departments they ensure timely responses to physicians and their staff.
Essential Functions and Responsibilities of the Job
Communicate effectively in a timely, proactive and professional manner.
Open communication with leadership regarding provider issues and facilitation of resolution.
Ongoing learning and increased knowledge of systems and initiatives.
Collaborate with multiple teams and vendors to ensure timely response to physician concerns.
Maintain a high level of productivity and self-direction as position is largely field based and must be available at all times.
Be at work and be on time
Follow company policies, procedures and directives
Interact in a positive and constructive manner
Prioritize and multitask
Essential Job Outcomes
Provide support to Physicians and their staff via in-person assistance, phone calls, emails
Leads detailed On-Boarding to new physicians and staff
First line of contact for all interdepartmental requests related to provider issues
Acts as liason to providers, escalating concerns to leadership as appropriate
Participates with activities and functions as they relate to physician growth as well as identifying network trends and gaps by working with internal departments and analyzing reports
Leads as primary contact for portal implementation and responsible for increasing portal enrollment
Collaborates with Contracting Department related to network management and ACO initiatives
Coordinates with customer service department to research and resolve provider issues
Reports any dissatisfaction among providers and resolves within limits of authority, reporting issue and resolution to the Provider Relations management team or supervisor
“Other duties as assigned”
Minimum of two years’ experience in health care, Provider Relations position required.
Epic or equivalent Managed Care electronic medical record system and provider portal applications knowledge preferred.
Experience with various healthcare industry regulatory agencies and requirements, including but not limited to CMS, NCQA, DMHC, ICE, DHCS, preferred.
Proficiency in Microsoft Office applications including Word, Power Point, Excel, and Outlook is a must.
Bachelor’s degree required.
List the education licensures or certifications preferred or required to do the job.
Internal Number: MEM003140
About MemorialCare Medical Foundation
Let us introduce ourselves. We're MemorialCare, a nonprofit health system that includes four hospitals, two medical groups, imaging centers, surgical centers and much more. As one of the leading health systems in Orange County and Los Angeles County, we're confident that no matter what your needs are, we have the teams, tools and know-how to support you every step of the way.