Provider Relations Specialist
Insight Global
Job Description
45% - Processing Participation Agreements and Associated Workflows/Agreements
Process Medicaid provider agreements and review data for deficiencies
Keep the customer relationship management (CRM) tool up to date
Ensure accuracy of records in CRM and JIRA
Send template emails Welcome packet, live connection and others to providers during the initial onboarding process
Process opt out requests, patient education requests, accountings of disclosures and terminations requests
Facilitate the Intake process
Assist with building reports on Medicaid-related projects and Medicaid beneficiary utilization of HIE services for NC Medicaid and the Centers for Medicare & Medicaid Services (CMS)
Develop efficiency roadmaps and standard operating procedures for Medicaid participant onboarding
Monitors Medicaid utilization of NC HealthConnex services and active enrollments
Provides recommendations to outreach team leaders for proactive and reactive outreach efforts
Coordinates and schedules time with Medicaid providers to gather feedback for continuous improvement efforts
Provide direct support to Medicaid providers and related work
30% - Customer Service
Provide education and answer questions to providers on a day to day basis on HIEs value-added services
Call screening for the NC HIEA main telephone line and providing appropriate responses to phone and email inquiries.
Ensure timely, helpful, and responsive communications to the provider community by relaying inquiries to other team members and closing the loop with providers.
Assisting providers with enrollment in services
Coordinating with Technical Support Help Desk to provide timely resolution to issues/inquiries.
25% - Project Support
Coordinate with Technical Support Help Desk:
o Audits
o DSM Directory
Support for Work Groups and Technical Analyst Team as needed
Manage monthly reporting from the CRM and provide those to leadership
Other duties as assigned by Business Relations Manager or Executive Director
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com .
To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ .
Skills and Requirements
Ability to explain and interpret program information to clients/customers and staff.
Working knowledge of Medicaid data collection and storage to compile, assimilate, and organize printed and electronic information
Experience working with Medicaid providers and/or health plans
Working knowledge of and ability to use correct spelling, punctuation, and specialized vocabulary.
Ability to convey information and ideas through a variety of media to individuals or groups; ability to adjust language or terminology to meet needs of the recipient(s).
Ability to present ideas in written form; ability to adjust language or terminology to meet needs of the recipient(s); ability to use correct grammar, organization, and structure.
Ability to utilize office equipment and other technology (software and systems) to meet work needs - proven experience with Microsoft Suite of Products and Adobe products.
Ability to facilitate the flow of work and coordinate office support activities with other staff; ability to maintain internal and external contacts for work coordination.
Ability to understand issues, identify problems and opportunities to determine the appropriate course of action. null
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal employment opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment without regard to race, color, ethnicity, religion,sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military oruniformed service member status, or any other status or characteristic protected by applicable laws, regulations, andordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or the recruiting process, please send a request to HR@insightglobal.com.
Confirm your E-mail: Send Email
All Jobs from Insight Global