Provider Relations Specialist

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.
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Facility: Fargo Health Plan

Location: Fargo, ND

Address: 1749 38th St S, Fargo, ND 58103, USA

Shift: 8 Hours - Day Shifts

Job Schedule: Full time

Weekly Hours: 40.00

Job Summary

The Provider Relations Specialist acts as the primary liaison between the Health Plan and its network providers, including physicians, hospital, and ancillary services. Responsible for daily communication with providers with respect to questions, concern, and complaints and therefore must have a broad understanding of the substantive and procedural aspects of the Health Plan. Knowledge of Managed Care-utilization management and provider reimbursement. Must be able to communicate effectively and with a high level of diplomacy with providers. Must assimilate large amounts of information to maintain a broad knowledge base. Should exercise good judgement in determining best methods of handling a variety of situations. Handles pressure effectively while maintaining confidentiality. Supports, develops and maintains relationships with provider networks. Responds to providers regarding policies, rates, changes, eligibility, credentialing etc. Occasionally train others regarding policies, procedures, online tools and other resources.

Department Details

This position requires you to be on the phone for the majority of your day. The hours for this position are Monday-Friday, 8-5pm.

Qualifications

Bachelor’s degree in Human Resources, Business or related field required.
Marketing/Sales training preferred.
Sanford is an EEO/AA Employer M/F/Disability/Vet.
If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to talent@sanfordhealth.org .

Job Function: General Administration

Req Number: R-33826

Featured: No