Provider Relations Representative
at Adventist Health System

Date Posted: 5/20/2017

Job Description

Job:  Other Non-Clinical Professional

Organization:  Adventist Health System Corporate Office

Shift:  Adventist Health System - Courtland

Job Posting:  Full-time

If you want to be a part of a place that provides nothing less than extraordinary compassionate care, then Adventist Health System is the place for you!
We are currently seeking qualified candidates for a Provider Relations Representative position that will be based in our PHSO Provider Operations and Engagement department. This position is based at our Keller Center in Maitland, FL.
The purpose of this position is to provide Network and Health Plan subject matter expertise, consultation and education to providers by establishing and maintaining a strong relationship with the providers and their practice staff. Provider Relations (PR) Representatives are expected to make regular visits to practice offices, with the intent to advise and educate on a wide variety of topics and Population Health Services Organization (PHSO) policies and procedures, facilitate issue resolution, education related PHSO initiatives and campaigns, etc.
The PR Representative is a role within the PHSO designed to provide valuable service to network providers and practices through relationship development, issue resolution, and front line communication related to information essential to provider’s day to day business dealings with the PHSO and its affiliated payer or employer contracts.
Specific job duties include:
  • Able to articulate important topics in a way which facilitates understanding, both amongst providers as well as other PHSO team staff.
  • Uses knowledge to help connect key concepts and expectations, ultimately presenting the PHSO, provider networks, and other affiliated payer networks in a manner that is simple for providers to relate to.
  • Regular rounding to communicate messages on behalf of the PHSO and payer/employer contracts about the value of policies and procedures, affiliated payer network quality programs and initiatives, and to ensure timely issue resolution.
  • On boarding providers for affiliated payer networks to ensure provider is informed and engaged related to essential information.
  • Facilitates the completion of affiliated payer / provider contracts and credentialing applications to ensure providers can be included into the network in an efficient manner.
  • Actively participates in continuing education topics for PR Representatives and suggests topics or items based on conversations occurring in the field or based on other perceived gaps in education.
  • Responsible for tracking, measuring, analyzing, and reporting on provider contacts, updating provider demographics, validating provider contact information, and reporting issues in the designated provider reporting tool.
  • Fully understands the provider and ancillary makeup of the payer contracts and affiliated payer networks in order to provide relevant feedback and intel related to potential needs.
  • Responsible for maintaining and understanding assigned territories including market attributes, providers in the community, and other pertinent information.
  • Works hand in hand with Population Management Advisors to facilitate the resolution of claims or other affiliated payer related issues that may arise with network providers.
  • Supports affiliated payer or provider network events through assisting with event communication and participating on location in any capacity needed.
  • Works seamlessly, effectively, and in harmony with all internal teams including, but not limited to, PHSO credentialing, provider resolution center, quality and care integration, provider education, analytics, and finance to ensure integrated operations that result in a superior consumer experience for the provider.

Job Requirements

Education Requirements:
  • Associate’s Degree or 3 years in a similar role
Experience Requirements:
  • 2+ years’ experience in performance improvement, operations, marketing or in a relevant physician/ hospital/ managed care environment.
  • 2+ years’ experience working collegially with providers
If this position sounds like a great match for your skills set and experience, please apply online now!

Job Snapshot

About Us

About Adventist Health System

Who We Are

We are one of the largest faith-based health care providers in the United States. For 150 years, we have carried on a tradition of providing whole-person care that not only addresses patients' physical ailments, but also supports their emotional and spiritual well-being. We demonstrate the same level of compassion and care for our employees as well, doing all that we can to help them realize their full potential – both personally and professionally.

Who You Are

You are a compassionate, talented professional who wants to work in an environment where you can live out your faith and your values. You are excited about being part of a team that uses the latest technology and medical research to ensure patients receive quality care, but who also recognize that great care is always personal. You enjoy going out of your way to make each patient and their family feel special, and are passionate about guiding them toward optimal health.

Our Community

Our community is global and so is our reach. From coordinating medical mission trips in Ethiopia to planting school gardens in Florida, we are constantly seeking ways to go beyond hospital walls in improving the health of our communities. As a member of our team, you will be encouraged to use your talents in fun, meaningful ways that bring joy and healing to people around the world.

Our Mission

Part of this worldwide network, Adventist Health System was founded in 1973 to support and strengthen the Seventh-day Adventist health care organizations in the Southern and Southwestern regions of the United States. Today it is a national leader in quality, safety and patient satisfaction, comprised of 46 hospital campuses and nearly 77,000 employees.

Although separated by geography, each of our facilities is united by the mission of Extending the Healing Ministry of Christ. Today we continue the tradition of whole-person care by practicing and sharing CREATION Health, a blueprint for living a healthy, happy life based on the principles given in the Bible’s creation story: Choice, Rest, Environment, Activity, Trust, Interpersonal relationships, Outlook and Nutrition.

We provide comprehensive benefits, training and advancement opportunities. We care for our employees as well as we care for our patients.