Senior Representative, Health Plan Provider Relations - Remote (Must Reside in MS) Molina Healthcare IncSenior Representative, Health Plan Provider Relations - Remote (Must Reside in MS)Southaven, MSRemotePerforms an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives; examples of such initiatives include: administrative cost-effectiveness, member satisfaction - Consumer Assessment of Healthcare Providers and Systems (CAHPS), regulatory-related, Molina quality programs, and taking advantage of electronic solutions (electronic data interchange (EDI), EMR, provider portal, provider website, etc.). Independently delivers training and presentations to assigned providers and their staff - answering questions that come up on behalf of the health plan; may also deliver training and presentations to larger groups, such as leaders and management of provider offices, including large multispecialty groups or health systems, executive level decision makers, association meetings, and joint operating committees (JOCs).
Provider Relations Representative I - Mississippi Avesis LLCProvider Relations Representative I - MississippiMS$20.13–$33.54 / hourWork in conjunction with Provider Relations Representative II to ensure that provider concerns are addressed (as applicable) Work closely and coordinates with Avesis Claims, Customer Service, Utilization Management, Clinical Management, Credentialing, Recruitment, Account Management, and other staff to develop operational solutions for various provider network projects. Knowledge of and intermediate ability to use various computer programs such as Microsoft Office including spreadsheets, databases, word processing and presentation software and programs/systems utilized in data analysis Core Competencies: Knowledge of dental health plan operations preferred.