Provider Relations Representative

Physician Relations Representative

Physician Relations Representative)

Field based position -3 travel days within the territory / 2 days remote

Full time - Monday- Friday

Must have a reliable auto

3 positions : Miami-Dade, Broward, Palm Beach ( 1 of each)

The Physician Relations Representative is responsible for fostering a strong and satisfied network of healthcare providers in a designated area.

They serve as the main liaison between practices, the company, and health plan partners. Their main focus is to work closely with providers to improve performance in areas like cost reduction, revenue optimization, quality enhancement, and provider satisfaction.

Requirements

• 4 years in healthcare or a related field
• 2+ years in Provider Relations, Network Management, Contracting, or Credentialing
• Experience with an ACO, MSO, Managed Care, Medicare Advantage Plan or related
• Must have experience in reviewing HEDIS, CMS Star Rating System, (MLR )Medicare Loss Ratio, (MRA) Medicare Risk Adjustment, and (RAF) Risk Adjustment Factor w / Providers
• Bachelor's degree in Marketing, Healthcare or related ( or work experience)
• Valid driver's license and reliable transportation required
• Ability to travel up to 60% within designated counties- 3 days in the field / 2 admin days remote
• Strong interpersonal and communication skills
• Experience in presentations
• Analytical and problem-solving skills
• Time management and organizational skills
• Attention to detail and reliability
• Proficiency in MS Office programs and Excel
• Bilingual in Spanish and English, for Miami territory only

Key Responsibilities :

• Work with providers on reviewing HEDIS, CMS Star Rating System, (MLR )Medicare Loss Ratio, (MRA) Medicare Risk Adjustment, and (RAF) Risk Adjustment Factor w / Providers
• Field Based position 3 days in the field and 2 remote office
• Provider Education and Support : Provide comprehensive education and tools to help providers meet quality and financial goals.
• Accountability and Performance : Understand and improve the financial performance of practices, ensuring they meet key performance indicators.
• Provider Training and Orientation : Conduct orientation sessions and ongoing training for providers and their staff.
• Provider Retentio n : Work to retain providers by ensuring their satisfaction with the organization.
• Provider Collaboration : Facilitate meetings to enhance patient outcomes and operational efficiencies.
• Performance Improvement Plans : Develop, implement, and monitor improvement plans for provider groups.
• Provider Negotiations : Negotiate contract terms and analyze proposals.
• Communication and Issue Resolution : Maintain open communication channels and resolve issues promptly.
• Strategic Planning : Collaborate to implement strategic interventions.
• Onsite Provider Visits : Spend most of the workweek visiting providers, with clear objectives for each visit.
• Engagement with Specialists : Focus on engaging high-quality specialists and improving coordination of care.

Compensation :

Base salary $85K- $100K Based on Experience (salary under review) plus bonus; Car allowance, 18 days PTO, fully subsidized health benefits, Holidays, 401k

Please submit your resume in a word document . If you are a match, a ttg Talent Solutions recruiter will contact you by phone, email or text. Please monitor your inbox.

At ttg, We believe in making a difference One Person at a Time ttg OPT.