Job Opportunities in United States
November 7, 2024
Arkos Health
South Burlington
FULL TIME
Director of Provider Relations
Our Organization:
Welcome to Arkos Health! We are a value-based healthcare company providing solutions for payors and providers by combining unique technology with in-home, virtual, and in-clinical care for patients. Backed by a robust technology platform, innovative software, and a light human touch, Arkos Health is committed to delivering advanced and accessible community-based services allowing our clients to live healthier, more independent lives. How do we do this? Arkos serves health plans and provider organizations by managing their highest-risk and highest-cost populations. Our goal is to be the most valued partner to health plans, service providers, and the community we collectively serve.
How You'll Make a Difference:
The Director of Provider Relations plays a critical role in ensuring high levels of provider satisfaction and development. This position supervises a team comprised of Provider Relations Representatives and Provider Education Coordinator. The Director of Provider Relations ensures providers are well informed of health plan and regulatory requirements and that these matters are clearly communicated to network providers, along with sharing assistive tools and metrics. The Director of Provider Relations works closely with the Education Group to conduct training sessions.
Essential Duties and Responsibilities:
Qualifications and Skills:
Benefits:
Arkos Health EEO Statement:
All Arkos Health divisions are Equal Opportunity Employers. We do not discriminate on the basis of race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status or any other status protected under federal, state or local laws.
Arkos Health is a drug free workplace. All job applicants selected for employment are required to submit to a pre-employment drug test and background check.
Arkos Health participates in E-Verify to confirm eligibility to work in the United States. To view the details on this program, visit our career page at Careers - Arkos Health
Welcome to Arkos Health! We are a value-based healthcare company providing solutions for payors and providers by combining unique technology with in-home, virtual, and in-clinical care for patients. Backed by a robust technology platform, innovative software, and a light human touch, Arkos Health is committed to delivering advanced and accessible community-based services allowing our clients to live healthier, more independent lives. How do we do this? Arkos serves health plans and provider organizations by managing their highest-risk and highest-cost populations. Our goal is to be the most valued partner to health plans, service providers, and the community we collectively serve.
How You'll Make a Difference:
The Director of Provider Relations plays a critical role in ensuring high levels of provider satisfaction and development. This position supervises a team comprised of Provider Relations Representatives and Provider Education Coordinator. The Director of Provider Relations ensures providers are well informed of health plan and regulatory requirements and that these matters are clearly communicated to network providers, along with sharing assistive tools and metrics. The Director of Provider Relations works closely with the Education Group to conduct training sessions.
Essential Duties and Responsibilities:
-
Leads all aspects of Provider Relations to include provider relations and operations to support provider service, provider education, and product and market expansions.
- Leads, develops, and trains staff to educate key individuals in provider groups regarding new approaches, products, reimbursement methodologies, appropriate coding including risk scores, quality measures and policy standards changes.
- Creates efficiencies for offices decreasing the administrative obstacles and assists in developing educational programs for staff and providers.
-
Ensures effective and timely provider communication, education and resolution of provider concerns:
- Ensures assigned provider offices have frequent and regular interactions with the Provider Relations Team.
- Tracks and reports on office visit activity by the Provider Relations Team.
-
Identifies provider issues and follow to resolution.
- Coordinates timely responses for provider issues involving referrals, prior authorizations, claims and credentialing issues in collaboration with the health plan.
- Conducts periodic office surveys on effectiveness of provider communications.
- Partners with the Education Group to conduct effective practice management programs and educational events.
- Assist health plan Marketing department with provider-specific marketing initiatives.
- Develops and implements a community outreach strategy with network providers including a communication plan to keep them informed of current issues.
- Develops strong relationships with outside partners, such as vendors and advisors, as well as internal partners, including department supervisors and co-executives.
-
Responsible for Provider Relations Team in managing strong working relationships with all providers; this may include in-office visits and out-of-office meetings with providers.
- Maintains efficient team structure and performance through analytics, processes and tools; maximizing new provider engagement; and working with the leadership team to develop plans to meet future needs.
Qualifications and Skills:
- Bachelor’s degree or equivalent experience in Business Administration, Healthcare Administration, or related field. MBA/MHA preferred. 5+ years of experience in customer service and provider relations in a health care or managed care environment.
- Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.
- Strong interpersonal and collaborative skills.
- Demonstrated experience and knowledge of CMS managed care contracting requirements.
- Experience working in a consensus building and matrix environments a plus. Previous health plan and provider representative experience preferred.
-
Benefits:
- Employer-paid Medical premiums at no cost to you
- Employer-paid Dental premiums at no cost to you
- Employer-paid Vision premiums at no cost to you
- Employer-paid Short-Term Disability premiums at no cost to you
- Employer-paid Life Insurance premiums at no cost to you
- Employer matching 401(k)
- 15 days annual combined sick/vacation and 9 days of holiday during your first year
- Your Birthday off!
Arkos Health EEO Statement:
All Arkos Health divisions are Equal Opportunity Employers. We do not discriminate on the basis of race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status or any other status protected under federal, state or local laws.
Arkos Health is a drug free workplace. All job applicants selected for employment are required to submit to a pre-employment drug test and background check.
Arkos Health participates in E-Verify to confirm eligibility to work in the United States. To view the details on this program, visit our career page at Careers - Arkos Health
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