Work in Iowa Healthcare Jobs

Job Information

Prime Therapeutics Provider Relations Manager- REMOTE in Des Moines, Iowa

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.

Job Posting Title

Provider Relations Manager- REMOTE

Job Description Summary

Manages the relationships with key health plans and provider networks for the purpose of implementing the company`s cost saving products into large markets nationally. Works daily to improve the relationships with health plan partners and resolves any outstanding issues that may develop. Increases the product for each health plan partner, and seeks medical cost saving programs for all members in the market. Enhances any process or procedure to best serve the Provider Network, and allows our program to be successful. Reports any high level issues for timely resolution and satisfaction.

Job Description

  • Establishes and maintains strong communications and collegial partnerships with providers.

  • Conducts provider education and training on an as needed, ongoing basis.

  • Takes the lead in responding to and resolving provider issues.

  • Facilitates problem-solving with other internal operations stakeholders and health plan provider relations personnel to achieve resolution and positive outcomes wherever possible for providers.

  • Assumes role in researching provider issues, collaborates with staff from various internal operations areas to determine root causes. Remedies problems, being on point to communicate with providers throughout the course of problem resolution.

  • Develops and maintains strategic and tactical approaches to relating to high-impact providers in the network that will distinguish the company in the industry and result in peak provider satisfaction.

  • Establishes and maintains optimal communication channels with client provider relations and account management to foster confidence in the company`s abilities to rapidly resolve provider issues.

  • Identifies opportunities for promoting broader use of web services and proactively communicates with providers not taking full advantage of these services to understand why.

Responsibilities

  • 5-8 years experience in a Provider Relations role for a managed care plan.

  • Bachelor's degree in a related field, or at least 4 additional years of experience in healthcare, network development, network management.

  • Solid knowledge of health plan operations required.

  • Depending on assigned business unit, knowledge or experience in management of medical drug benefits, specialty pharmacy, pharmacy benefits management (PBM), behavioral health, or radiology may be required.

Work Experience

Work Experience - Required:

Network

Work Experience - Preferred:

Education

Education - Required:

A Combination of Education and Work Experience May Be Considered., Bachelors

Education - Preferred:

Masters

Certifications

Certifications - Required:

Certifications - Preferred:

Potential pay for this position ranges from $59,610.00 - $95,370.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (https://www.primetherapeutics.com/careers/benefits/) and click on the "Benefits at a glance" button for more detail.

Prime Therapeutics LLC is an Equal Opportunity Employer. We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, genetic information, marital status, family status, national origin, age, disability, veteran status, or any other legally protected class under federal, state, or local law.

Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.

If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.

Prime Therapeutics LLC is an Equal Opportunity Employer. We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. ‚Äč If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email Careers@primetherapeutics.com.

DirectEmployers