Provider Relations Specialist

3 weeks ago

Bacolod City, Western Visayas, Philippines Pioneer Your Insurance Full time

Job Summary: Cultivates and optimizes relationships with healthcare providers in the assigned area, ensuring an effective network that delivers high quality care to HMO members.

Primary Duties and Responsibilities of the Provider Relations Staff:

  • Initiate and assist the Manager in the new and renewal contracts of prospective and accredited providers (hospitals, clinics, doctors) and in conducting provider-relations visits to existing providers, particularly those with difficult doctors, and visiting hospitals during times of suspension.

  • Data encoding and gatekeeping of Providers and Physician data in the system.

  • Educate providers on administrative policies and procedures.

  • Provide assistance to the internal team on a case-by-case basis.

  • Prepare and release warning letters, memoranda, and other similar communications to Providers and Physicians, if necessary.

  • Collate and organize reports of the team forsubmission to Immediate Heads.

  • Take charge in case the Immediate Head is on leave or attending business meetings outside the company.

  • Help facilitate the resolution of provider-related concerns/complaints.

  • Undertake all other tasks that may be assigned from time to time.

Job Qualifications:

  • College Graduate (BS Nursing, Psychology, etc.)

  • With at least 3 years' experience on the same role (Healthcare)

  • Proficient in the use of Microsoft Office tools

  • Must be willing to travel

  • With excellent attention to detail, Organizational Savvy and Results oriented

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