Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.
What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.
If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.
SCOPE OF ROLE
Our Markets team is responsible for partnering with our Care Partners (CPs) to turn their provider networks into market leading integrated delivery systems. As a Provider Relations team member, you will manage provider communications, service, issue resolution intake, case submission, case closure, as well as data management to and from our Care Partner and other providers in the market to build the foundation for a strong connection between Bright and our provider partners. Provider Relations team members are also expected to onboard new practices and CPs, including providing orientations, in-person visit, and education with how to work with Bright.
The Senior Provider Relations Specialist description is intended to point out major responsibilities within the role, but it is not limited to these items.
- Provider Account Management
- Ongoing, professional, and effective touchpoints with all active providers in Bright’s network
- Relationship manager for Care Partner provider relations’ staff
- Provide high level of customer service
- Provider Education and Network Management
- Proactive research and resolution of provider issues including but not limited to claims submission, processing, and payment; contracting details; provider tools; and UM and other protocols
- Ensure accurate ongoing collection of key provider data element updates and changes
- Supporting providers through the credentialing/re-credentialing process, including addressing provider questions, ensuring timely completion of applications, and supporting the Bright Health credentialing team
- Hold education sessions for providers to ensure alignment and understanding of Bright Health
- Collaborate with Care Partner Provider Relations staff in the creation and distribution of orientation and educational materials to all levels of personnel within a hospital, ancillary services or physician office setting
- Build provider awareness of and engagement with Bright Health
- Cross-functional Bright support
- Serve as internal Bright Health provider advocate by communicating key provider pain points and working with key stakeholders to advance our support of our contracted providers
- Collaborate with Marketing, Sales, Provider Data, Credentialing, Operations, HOT, and other teams to coordinate cross-functional in-market activities.
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
- High School Diploma or GED required; Bachelor’s degree in Business, Health Care Administration, Communications or a related field is preferred; equivalent work experience and education will be considered in lieu of a degree
- Three (3) or more years of experience in the healthcare industry navigating relationships around providers and insurance networks is preferred
- Strong verbal and written communication skills
- Possess strong business acumen and professionalism
- Demonstrated ability to serve in a customer (provider) facing role and collaborative and relationship-driven style in building effective data transmissions between entities
- Proficiency with the Microsoft Office suite
The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer. Some travel may be required.
Bright Health is committed to following the federal government guidelines for vaccination requirements, ensuring the safety of our employees, and helping protect the people we serve. Certain positions, including this position, require full vaccination against COVID-19 (including any booster shots if required), where allowable under the law, unless approved for a reasonable accommodation based on a medical condition or religious belief.
We’re Making Healthcare Right. Together.
We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.
We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.