Provider Relations and Engagement Consultant (Texas or Georgia)

About the role:  As a Provider Relations and Engagement Consultant at XO Health, you will play a vital role in maintaining positive relationships with healthcare providers within our network. Your primary responsibility will be to ensure effective communication and collaboration between our company and healthcare providers to ensure seamless delivery of high-quality care to our members. You will serve as a liaison between the company and providers, addressing their inquiries, resolving issues, and facilitating effective network management. You will also help drive quality and cost performance with XO Health High Performance Network providers that are in value-based care contracts.  The ideal candidate is detail-oriented, possesses excellent communication skills, and has a strong understanding of healthcare operations and insurance processes. This position can be located in either Texas or Georgia. 

 Responsibilities:

• Establish and maintain positive relationships with healthcare providers in the company's network.
• Serve as the main point of contact for provider inquiries, concerns, and escalations, ensuring prompt and accurate responses.
• Collaborate with internal departments such as Claims, Network Development, and Member Advocacy to address and resolve provider-related issues and inquiries.
• Assist in the onboarding process of new providers, ensuring accurate and timely completion of required documentation.
• Coordinate and facilitate provider meetings, training sessions, and educational programs to enhance their understanding of company policies, procedures, and initiatives.
• Monitor provider performance and satisfaction, conducting regular assessments and implementing improvement strategies when necessary.
• Identify opportunities and develop action plans for providers to improve cost and quality outcomes.
• Stay updated with industry trends, changes in regulations, and market dynamics related to provider relations, sharing relevant information with internal stakeholders as needed.
• Generate reports and maintain accurate records of provider interactions, inquiries, and issue resolutions.
• Travel by air and car for in-person meetings with providers for up to 2-3 days, as needed.

Qualifications:

A qualified candidate will likely have:

• Bachelor's degree in healthcare administration, business administration, or a related field. Relevant experience may be considered in lieu of a degree.
• Previous experience in provider relations, network management, or a related field within the healthcare industry is highly desirable.
• Strong knowledge of healthcare operations, medical terminology, and insurance processes.
• Excellent communication skills, both written and verbal, with the ability to effectively communicate complex information to diverse audiences.
• Exceptional interpersonal skills with the ability to create and maintain positive, trusting relationships with healthcare providers and internal stakeholders.
• Detail-oriented with strong organizational and problem-solving abilities.
• Proficient in using Microsoft Office Suite and other relevant software applications.
• Familiarity with healthcare regulations and compliance requirements.
• Ability to work independently and as part of a team in a fast-paced environment.
• Flexibility to adapt to changing priorities and handle multiple tasks simultaneously.

Key Personal and Professional Attributes: 

• Can work collaboratively internally and externally.
• is self-assured and results oriented.
• Brings strong financial acumen and analytical and problem-solving skills.
• Is commitment to the startup.