City - Remote SD, SD, USA
2 days ago
Provider Relations Specialist - Health Plan Contracting

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We’re proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. 

Work Shift:

Day (United States of America)

Scheduled Weekly Hours:

40

Salary Range: $21.50 - $34.50

Union Position:

No

Department Details

While this position is primarily remote, some in-person attendance will be required for trainings, team meetings, or special projects. These on-site responsibilities will be scheduled in advance.

Summary

The Provider Relations Specialist acts as the primary liaison between the Health Plan and its network providers, including physicians, hospital, and ancillary services.

Job Description

Responsible for daily communication with providers with respect to questions, concern, and complaints and therefore must have a broad understanding of the substantive and procedural aspects of the Health Plan. Knowledge of Managed Care-utilization management and provider reimbursement. Must be able to communicate effectively and with a high level of diplomacy with providers. Must assimilate large amounts of information to maintain a broad knowledge base. Should exercise good judgement in determining best methods of handling a variety of situations. Handles pressure effectively while maintaining confidentiality. Supports, develops and maintains relationships with provider networks. Responds to providers regarding policies, rates, changes, eligibility, credentialing etc. Occasionally train others regarding policies, procedures, online tools and other resources.

Qualifications

Bachelor’s degree in Human Resources, Business or related field required.

Marketing/Sales training preferred.

Sanford is an EEO/AA Employer M/F/Disability/Vet. 


If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to talent@sanfordhealth.org.

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