Job Title: Provider Relations Specialist
Department: Provider Relations

About the Role:

We are currently seeking a highly motivated Provider Relations Specialist. This role will report to the Sr. Manager – Provider Relations and enable us to continue to scale in the healthcare industry.

You are:

• Comfortable with ambiguity and biased towards action
• Relentlessly resourceful
• Growth-oriented
• Mission-driven

What You'll Do:

• Maintain professional etiquette at all times, especially when working with Providers
• Must be able to have effective interaction with providers
• Responsible for New Provider and office staff orientations and continued education of existing providers to ensure company programs and initiative (i.e., P4P, HCC, Encounter, etc.) and process is being effectively communicated. Ensure provider is effectively utilizing company tools available to them
• Ability to handle provider concerns in an empathetic and caring manner (i.e., authorization, claims, compliances, etc.)
• Must be able to problem solve and identify ways to address provider issues effectively
• Develop collaborative relationships with Doctors, Office staff, Health Plan representatives
• Participate and conduct provider network administration functions including but not limited to: provider status changes, internal reporting, member transfers, and data reports distribution to contracted providers
• Internal network liaison for other departments (i.e., Data Management, Claims and Quality Management Departments.)
• Report to management on what provider network needs and how to further enhance the organization
• Highly motivated and able to work with multiple teams simultaneously
• Facilitate meetings with contracted providers, health plan, and marketing events
• Must be able to travel frequently to assigned service area
• Other duties assigned by department Director

Minimum qualifications:

• An undergraduate degree from an accredited institution of higher learning required; or minimum of three (3) years relevant work experience in Network Management, Provider Relations in a managed care setting, health plan or large medical group administration.
• Excellent oral and written communication skills.
• Detail oriented and possess strong organizational skills in a fast-pace environment.
• Proven in MS Office programs (i.e., Excel, Word, Outlook and PowerPoint)
• Individual must have an understanding of Managed Care Operations (i.e., patient referrals, claims process, eligibility information, contracting, HEDIS, HCC etc.).

Who We Are:

ApolloMed (NASDAQ: AMEH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise in order to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient.

Our platform currently empowers over 10,000 physicians to provide care for over 1.2 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise in order to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.

Our Values:

• Patients First
• Empowering the Independent Provider
• Be Innovative
• Operate with Integrity & Deliver Excellence
• Team of One

Environmental Job Requirements and Working Conditions:

• This position is in office. The office is located at 9700 Flair Drive, El Monte, CA 91731.
• The target pay range for this role is between $18.00 - $36.00 per hour. This salary range represents our national target range for this role.

ApolloMed is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@networkmedicalmanagement.com to request an accommodation.

Additional Information:

The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

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