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Sanford Health Provider Relations Specialist - Health Plan - Provider Relations in Fargo, North Dakota

Job Title: Provider Relations Specialist | Health Plan - Provider Relations | Fargo

City: Fargo

State: ND

Department : SHP - Provider Relations - Fargo

Job Schedule: Full Time

Shift: Varies

Hours Per Shift: 8 hr

JOB SUMMARY

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

POSITION RESPONSIBILITIES

Maintains a sense of urgency and a positive attitude.;Identifies information within own function that cannot be disclosed.;Actively participates in team meetings.;Processes large quantities of detailed information with high levels of accuracy.;Learns new concepts, processes and tools related to own immediate responsibilities.;Contributes to the establishment of good coaching practices.;Responds to day-to-day operational priorities while still making progress on project work.;Uses logic and intuition to make inferences about the meaning of the data and arrive at conclusions.;Communicates well downward, upward, and outward.;Uses the Office document collaboration features in a workgroup.;Ensures identification of customer needs and priorities.;

DEPARTMENT DETAILS

Healthcare or insurance experience necessary for this position. This position is telephonic.

QUALIFICATIONS

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

Marketing/Sales training preferred.

About Sanford Health:

At Sanford Health, we are dedicated to the work of health and healing.

Every day, we show that commitment by delivering the highest quality of care to the communities we serve.

We are leaders in health care and strive to provide patients across the region with convenient access to expert medical care,

leading-edge technologies and world-class facilities.

In addition to strong clinical care, we are also committed to research,

education and community growth. We engage in medical research to not only discover innovative ways to provide care, but also cures for common diseases.

We continuously seek new ways to achieve our vision of improving the human condition

here in your community, across the region and around the world.

The entire team at Sanford Health recognizes the value of healthy families

and communities. We continue to gain momentum and expand our reach. Together, we can make a positive difference now, and in the future.

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 .

City: Fargo

State: ND

Job Function: Health Plan

Job Schedule: Full Time

Shift: Varies

Req Number: WD09819

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