Provider Relations Representative

Job Description

Primary Responsibilities

• Establishes strong relationships with physicians and their teams / partners.
• Acts as the primary point of contact for health plan operations for a market and cultivates collaborative and influential relationships with each physician / partner.
• Works to enhance relationships. Serves as an internal advocate for the needs of physician practices.
• Increases knowledge of EHI / Lumeris. Works to understand the operating practice and various practice workflows. Provides valuable insight to providers to further their goals and strategies.
• Utilizes knowledge of who to go to for different issues to ensure issues are resolved in a timely manner.
• Helps respond to internal requests (charts, audits, grievances, etc.) and Provider Engagement email bucket.
• Supports other projects as needed which may include handling AEP materials.

Qualifications

• Bachelor's Degree in Healthcare Administration, Business Administration, or other related field or equivalent
• 3+ years of relevant experience or the knowledge, skills, and abilities to succeed in the role
• Good understanding of the change management cycle
• Firm understanding of the healthcare industry and current trends
• Working knowledge of any of the following areas : Medicare advantage, Medicare Shared Savings Program (MSSP), managed care regulations, quality reporting, care management, population management, ACO strategy implementation and operations, and supporting providers in risk-based contracts
• Solid client-facing, collaboration, and interpersonal skills with the ability to foster relationships at all levels
• Ability to prioritize workload and meet deadlines while operating in a fast-paced and dynamic environment
• Good critical thinking and problem solving skills, including the ability to understand and utilize basic healthcare metrics
• Solid team work, communication, and presentation skills

Preferred

Master's Degree

Working Conditions

While performing the duties of this job, the employee works in normal office working conditions.

Disclaimer

The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required.

The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job duties and responsibilities.

Lumeris is an EEO / AA employer M / F / V / D.

The hiring range for this position is :

$49,200.00-$63,000.00

Factors that may be used to determine your actual pay rate include your specific skills, experience, qualifications, location, and comparison to other employees already in this role.

This role may also be eligible for incentive compensation. At Lumeris, we are committed to providing a total rewards package that supports your overall well-being.

Our benefits include medical, vision, dental, well-being programs, 401(k) with company matching, life insurance, paid time off including paid leave, and so much more.

Learn more by visiting our Careers Page.

Member Facing Position :

No- Not Member or Patient Facing Position

Location :

Chicago, IL, Illinois, Indiana

Time Type : Full time

Full time

Lumeris and its partners are committed to protecting our high-risk members & prospects when conducting business in-person.

All personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine.

If this role has been identified as member-facing, proof of vaccination will be required as a condition of employment.