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Provider Experience Cons

Company: The Judge Group
Location: Austin
Posted on: September 23, 2022

Job Description:

Location: Austin, TX
Description: Are you looking to join a well-known company? Are you looking to gain access into the - - - - - - - - - - - - - - - - -Healthcare field with a company that - provides you with all the tools to succeed and grow into a Senior Leader at the company. If this is something that interests you keep reading! If not, well this is a time to learn about new opportunities in life. If you have continued reading, our client has an immediate need for someone with your background and skills. I would love to have a conversation about the role and your responsibilities while on the job. For your reference, I have included the job description. If this is something that interests you, send me an email at Let have a conversation and let's get you a job! Feel free to reach out with any questions you may have! Job Details: Job Title: Provider Experience member Location: -Remote (Must reside in Texas) Length of Engagement: 6-12 month contract Rate: Competitive pay Responsible for providing quality, accessible and comprehensive service to the company's provider community. Develops and maintains positive provider relationships with provider community by regular on-site and/or virtual/digital visits, communicating administrative and programmatic changes, and facilitating, education and the resolution of provider issues. Serves as a knowledge and resource expert regarding more complex provider issues impacting provider satisfaction; researches and resolves complex provider issues and appeals for prompt resolution. Works with internal matrix partners to triage issues and submit work requests. Is primarily assigned higher level, Tier 1/Platinum providers, but will handle Tier 2 and 3-- - -s as well. Functions as a high level technical resource to resolve or facilitate complex provider issues. Coordinates Joint Operation Committees (JOC) of Tier 1 /Platinum provider groups, driving the meetings in the discussion of issues and changes. Provides assistance regarding Annual Provider Satisfaction Surveys and required corrective action plan implementation and monitoring, education, contract questions and non-routine claim issues. Coordinates communications process on such issues as administrative and medical policy, reimbursement and provider utilization patterns. Coordinates Provider Manual updates/maintenance. Organizes and executes external Provider Townhalls/Seminars and attends State Association conferences (e.g.: MGMA, AFP, AAP, HFMA). Coordinates prompt claims resolution through direct contact with providers, claims, pricing and medical management department. Identifies and reports on provider utilization patterns which have a direct impact on the quality of service delivery. Researches issues that may impact future provider negotiations or jeopardize network retention. Requires a Bachelor's degree and a minimum of 5 years of customer service experience including 2 years of experience as a Network Management Rep; or any combination of education and experience, which would provide an equivalent background. Travel may be required.

This job and many more are available through The Judge Group. Find us on the web at

Keywords: The Judge Group, Austin , Provider Experience Cons, Other , Austin, Texas

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