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Sr. Provider Relations Representative - CGS

BlueCross BlueShield of South Carolina
W@H Tennessee, United Statesfull_timeVerifiedPosted 24 Sept 2024

About the role


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

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Company

BlueCross BlueShield of South Carolina

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