Provider Relations Specialist Job at One Call

Job Description

Join Our Team and Make a Difference! Are you looking for an impactful role where you finish the workday knowing you helped someone? Whether you are part of our care coordination team or playing a supporting role, the work our colleagues do every day enables us to collectively reach our mission of getting people the care they need when they need it. By staying committed to our core values of Think Big, Go Fast, Deliver Awe, and Win Together we can positively impact the lives of the injured workers we serve and get them back to the things that matter most in life.

Job Responsibility

To initiate proactive outreach and provide ongoing training and education to providers specific to One Call policies and procedures
Manage network complaints including the initial investigation and appropriate follow-up via written and verbal communication, as the situation dictates, while maintaining timely resolutions to the submitting party
Identify patterns of non-compliance, and institute appropriate remediation plans with the goal of improved provider performance
Ability to identify root causes of each reported complaint in order to accurately track and trend non-compliant matters
Act as a liaison for any provider questions and concerns
Prepare and submit monthly reports as part of the proactive provider oversight
Complete Provider Quality and Credentialing (PQC) committee forms, as needed, for monthly presentation to PQC as well as all necessary actions associated with committee decisions
To align with Provider Relations Managers to ensure all provider issues, concerns, and success are well monitored and addressed
Orchestrate conference calls with Providers as well as necessary internal departments in order to rectify issues, enhance Provider education as well as promote positive Provider relationships
Elevate provider relationships to partnerships
Identify mutually beneficial growth opportunities between One Call and providers and coordinate with the appropriate Provider Relations Managers to implement
Special projects as business requirements dictate

Requirements

Experience requirements: Bachelor's degree preferred or the equivalent combination of education, training, and work experience
Strong critical thinking skills and problem-solving abilities
In-depth knowledge of One Call's products and services, business practices, and processes
Broad knowledge of the workers' compensation industry practices, regulations, and processes
Proficiency in MS Word, Excel, and Outlook
Working knowledge of One Call legacy platforms
Ability to work in an environment that aligns with the company's diversity, equity, inclusion, and belonging standards
Ability to work both independently and in a team environment
Demonstrate our core values of Think Big, Go Fast, Deliver Awe, and Win Together

What we offer

Remote Work
Generous Time Off: Besides 8 company holidays and 2 personal days every year, all colleagues receive a minimum of 18 days of paid time off
Comprehensive Benefits Package: Including medical, dental, vision, and pet insurance
401(k) matching program
company-paid life insurance and short and long-term disability coverage
Supportive Services: Colleague Assistance Program that provides free counseling and financial services
One Call Foundation, a non-profit arm of our company, provides colleagues financial assistance during times of unexpected hardships

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Provider Relations Specialist

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