JOB SUMMARY/PURPOSE
- Serve as an advocate for providers by ensuring they are informed, supported, and educated on Samaritan Health Plans’ procedures, benefits, policies, and available provider tools
- Coordinates and provides administrative support to the Network Contracting and Relations team
- Partners with internal departments to research, coordinate, and resolve provider-related issues, ensuring timely and accurate follow-through
- Document all provider interactions and outcomes in internal systems
- Support implementation and onboarding of new providers, including credentialing follow-up and demographic updates
- Monitor, track, and follow up on provider issues; escalate complex or unresolved items as needed
- Assist in maintaining accurate provider directories by validating demographic and operational information
- Participate in Network Management projects and initiatives to support departmental goals
- Support cross-functional collaboration to resolve routine provider operational concerns
DEPARTMENT DESCRIPTION
- The Network Management / Provider Relations department is responsible for developing, supporting, and maintaining relationships with the provider network across all product lines
- The team ensures providers have the information, resources, and operational support needed to deliver high-quality care to plan members
- The department collaborates with internal stakeholders including Claims, Utilization Management, IT, and Configuration to resolve provider issues and improve overall provider satisfaction
EXPERIENCE/EDUCATION/QUALIFICATIONS
- Bachelor’s degree or equivalent combination of education and relevant experience within the health care industry required
- Strong organizational skills with the ability to manage multiple priorities effectively
- Excellent written and verbal communication skills
- Proficiency in Microsoft Office applications (Word, Excel, Outlook, PowerPoint) required
- Health plan experience strongly preferred, particularly in one or more of the following areas:
- Provider Relations
- Referral Authorization
- Provider Data Maintenance
- Claims Processing
KNOWLEDGE/SKILLS/ABILITIES
- Data entry accuracy
- Organization and time management
- Basic managed care concepts
- Communication and collaboration
- Ability to follow SOPs
- Detail orientations
Shift: Days (0800-1700)
- Remote, no weekends
Specialty Type: Clerical
Sub Specialties: Clerical/Office Assistant/Support
General Certifications: N/A
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