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Job Posting Title

Job Description

The Provider Relations Specialist is responsible for supporting the provider communication and education portion of new client implementations, and the ongoing daily support of the existing client networks of providers. This position is responsible for researching and resolving standard provider inquiries and technological challenges.

Responsibilities

• Research and resolve provider inquiries in a timely manner.
• Support or manage provider communication and education workgroups as needed to facilitate successful implementations of new health plans.
• Conduct monthly outreach calls to provider offices utilizing phone or fax for prior authorization submissions and encourage web submissions as the preferred alternative
• New user provisioning for provider portal with ongoing education and troubleshooting support
• Participate as assigned to support provider relations initiatives.
• Other duties as assigned

Education & Experience

• Bachelor's degree in Business or related area of study, or equivalent combination of education and/or relevant work experience
• 2 years of work experience in Provider relations and Medical pharmacy
• Must be eligible to work in the United States without need for work visa or residency sponsorship

Additional Qualifications

• Ability to work in a largely self-directed environment
• Available for occasional overnight travel
• Critical thinking skills and ability to anticipate issues and develop innovative solutions
• Ability to manage competing priorities and deadlines
• Experience working in provider relations
• Proficient with Microsoft Office (Excel, Access, Word, PowerPoint)

Preferred Qualifications

• Bachelor’s degree in Business Administration, Healthcare or related field

Physical Demands

• Ability to work a flexible schedule including shifts outside of Prime's core business hours of 8:30 a.m. to 5 p.m. local time
• Constantly required to sit, use hands to handle or feel, talk and hear
• Frequently required to reach with hands and arms
• Occasionally required to stand, walk and stoop, kneel, and crouch
• Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.