Provider Relations Representative

Assists in developing and managing a medical and routine eye care provider network for assigned territory. Responsible for relationship management with designated provider groups and their staff and executing with provider groups on initiatives that benefit the customer, provider, and health plan.

Essential Functions

Assist with the general oversight of the provider network in assigned territory, including financial performance, quality initiatives, provider data accuracy, trend analysis, and provider engagement (particularly vision care providers and ASCs)

Collaborate with Director of Provider Relations on strategic plans for growth, development, and vision for assigned territory

Participate with manager in monthly financial review with senior management

Assist in managing key partner relationships for assigned territory

Develop and maintain relationships with providers, practice managers, and care coordination teams with health system/large clinic partners within the provider network to drive optimal performance on STARS, coding, utilization, and overall financial performance

Job Specifications

Typically has the following skills or abilities:

Bachelor's degree

Minimum two years of expertise in provider relations or managed care.

Experience with routine/medical eye care providers

Requires at least 15% local travel to network providers

Car & valid driver's license required (mileage reimbursement provided)

Preferred Skills

Utilization management and claims adjudication experience

#LI-REMOTE

The compensation range for the role is listed below. Applicable salary ranges may differ across markets. Actual pay will be determined based on experience and other job-related factors permitted by law. As a part of the compensation package, this role may include eligible bonuses and commissions. For more information regarding iCare benefits, please click here.