Sr. Provider Relations Representative - CGS

Summary
 Provides education and training for network providers/staff/suppliers/physicians/beneficiaries/referral agents as necessary. Develops and produces all training and educational materials.
Description
 

What You’ll Do:

• Develops/prepares/reviews/updates all provider education materials.
• These may include: web-based training, computer-based training, ACT (ask the contractor) calls, outreach presentations/proposals, listserv articles, new highlights, calendar of events, job aids, resource tools, and web page content.
• Conducts/facilitates meetings, workshops, training classes, teleconferences with providers, provider groups, staff, suppliers, physicians, beneficiaries, referral agents.
• Develops relationships with providers, provider groups, staff, suppliers, physicians, beneficiaries, referral agents, state/local medical/professional associations.
• Responds to educational needs.
• Acts as liaison between division/above mentioned groups and appropriate state/federal agencies to ensure training needs are met.
• Responds to/resolves problems/issues identified through meetings, workshops, correspondence, etc.
• Performs administrative functions in support of education and training.
• Produces/generates various reports to management and provides feedback on activities to management.
• Contributes/participates/completes special projects as assigned.
• Work environment: Typical office environment. Work may involve some travel between office buildings. Some frequent/out-of-town travel may be required.

To Qualify for This Position, You’ll Need:

• Bachelor's degree OR Four (4) years of job-related work experience OR Four (4) years combined job related education and experience.
• Four (4) years of experience in customer service, claims processing, communications, education/training, provider relations, healthcare or combination. (Can be concurrent)
• Demonstrated skills related to training materials development.
• Demonstrated skills related to classroom presentations to large groups.
• Working knowledge/understanding of government healthcare programs, HIPAA policies, procedures.
• Demonstrated proficiency in word processing, spreadsheet, database software.
• Good judgment skills. Demonstrated proficiency in spelling, punctuation, grammar skills.
• Demonstrated verbal and written communication skills.
• Analytical and critical thinking skills.
• Basic business math proficiency.
• Ability to persuade, negotiate, or influence others.
• Ability to handle confidential or sensitive information with discretion.
• Ability to identify learning objectives.
• Strong course design skills to include use of media/other instructional methods.
• Ability to evaluate progress in addition to actual delivery of training sessions.
• Microsoft Office.

We Prefer That You Have:

• Prior Provider Relations Representative experience.

What Blue Can Do For You:

Our comprehensive benefits package includes:

• 401(k) retirement savings plan with company match
• Subsidized health plans and free vision coverage
• Life insurance
• Paid annual leave — the longer you work here, the more you earn
• Nine paid holidays
• On-site cafeterias and fitness centers in major locations
• Wellness programs and a healthy lifestyle premium discount
• Tuition assistance
• Service recognition

What to Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications.  This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.  Management will be conducting interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the preferred qualifications.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

Some states have required notifications. Here's more information. 

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains Affirmative Action programs to promote employment opportunities for minorities, females, disabled individuals and veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities.

If you need special assistance or an accommodation while seeking employment, please e-mail [email protected] or call 1-800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.