Job title: Provider Relations Representative, Consultant (Short Term Employment)
Company: Blue Shield of California
Job description: Job Description:Your RoleThe Network Management team is responsible for the development and maintenance of all provider networks, including vendor and Plan to Plan relationship necessary to provide our members and clients with access to quality, affordable health care services. The Provider Relations Consultant will report to the Provider Relations, Senior Manager. In this role you will support Blue Shield of California’s CalPERS line of business programs, including supporting Plan to Plan operations.*This is a Short-term Employment (Temporary/Full-Time) role.Your WorkIn this role, you will:
- Implement strategies with providers to improve provider performance.
- Develop and keep good working relationships with the provider community.
- Serve as liaison between the company and the provider community to resolve questions or problems such as contract interpretation, product/program implementation, and claims administration.
- Ensure provider compliance with company policies and contractual agreement.
- Identify potential network participants and promote provider participation in Blue Shield of California programs and networks to increase and enhance the company’s competitive position in the marketplace.
- Conduct provider orientations, communicating company policies, procedures, products, or services.
- Aid with provider negotiations and may negotiate selected agreements.
- Manage complex provider relationships and function as the primary contact while showing the ability to influence providers and build a strong provider relationship
- Represent Network Management at internal meetings and present and communicate on behalf of Network Management to stakeholders and/or Network Management leadership
- Collaborate with various functional areas, influence providers, be a collaborator, interact with different stakeholders of the organization and cultivate business relationships with various constituents
Qualifications:Qualifications and Experience
- Requires a college degree or equivalent experience and minimum 7 years of prior relevant experience
- Requires excellent analytical and problem-solving skills.
- Requires deep knowledge of job area typically obtained through advanced education combined with experience.
- Viewed as a specialist within discipline. May have broad knowledge of project management.
- Requires a minimum of 3 years of Provider Relations experience
- Requires experience in provider outreach
- Requires the ability to build strong relationships both internally and externally
- Requires strong written and verbal communication skills
- Knowledge of provider contracting process is preferred
- Experience of onboarding providers is preferred.
- Ability to manage multiple projects is preferred
Pay Range:The pay range for this role is: $ 96470.00 to $ 144760.00 for California.Note:Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate’s experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.About the Team:Blue Shield of California’s mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our continued commitment to diversity, equity, and inclusion upholds our values and advances our goal of creating a healthcare system that is worthy of our family and friends while addressing health disparities, promoting social justice, and integrating health equity through our products, business practices, and presence as a corporate citizen.Blue Shield has received awards and recognition for being a certified Fortune 100 Best Companies to Work, Military Friendly Employer, People Companies that Care, a Leading Disability Employer, and one of California’s top companies in volunteering and giving. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!Our Values:
- Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we’re going to do and by acknowledging and correcting where we fall short.
- Human. We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes.
- Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.
Our Workplace Model:Blue Shield of California is dedicated to making work-life balance a reality. Whether you prefer to work in an office or from home, we understand flexibility is more important than ever. That’s why Blue Shield is a hybrid company, offering you the opportunity to decide where you can do your best and most meaningful work.Two ways of working: Hybrid (our default) and office
- Hybrid – In a business unit approved office a few times per year to 3 days per week, on average
- Office – In a business unit approved office 4+ days a week, on average. If the role you’re applying for is deemed an “Essential Role,” the company has determined that the role can only be performed in a Blue Shield office or in the field and would require your to meet the office worker classification.
Physical Requirements:Office Environment – roles involving part to full time schedule in Office Environment. Due to the current public health emergency in California, Blue Shield employees are almost all working remotely. Based in our physical offices and work from home office/deskwork – Activity level: Sedentary, frequency most of work day.Equal Employment Opportunity:External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.
Expected salary: $96470 – 144760 per year
Location: El Dorado Hills, CA
Job date: Thu, 29 Aug 2024 03:15:15 GMT
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