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McLaren Health Care Provider Relations Rep II IN in Indianapolis, Indiana

Description

MDwise, Inc. Opportunity – Provider Relations Representative II - Behavioral Health (Northern Indiana region)

MDwise is your local, Indiana-based nonprofit health care company. We were founded in 1994 to help vulnerable populations needing health coverage in Indiana. Our parent organization, McLaren Health Care at https://www.mclaren.org/main/home.aspx , is a nonprofit integrated health system who believes all Indiana families should have access to high quality health care regardless of income. Our mission is to provide high quality health care. MDwise works with the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise and Healthy Indiana Plan health insurance programs.

As an employee of MDwise, you will be a part of a dynamic organization that considers all of our employees as leaders in driving the organization forward and delivering quality service to all our members. The successful candidate for this role will join our Provider Relations team to service our Behavior Health Providers in the Northern Indiana region. This region would include all Providers north of the area from Terre Haute to Indianapolis to Richmond. There may be reconsideration of this territory depending on the hired candidate's location.

Position Summary:

Responsible for the education and servicing of assigned provider groups regarding all aspects of the Plan and its subsidiaries. Responsible for assisting in the development of policy, procedures, and educational materials for use with all Provider Programs and for the development of benchmarks to measure performance against the Plan’s goals. Establishes and maintains effective relationships with key administrative executive staff of contracted medical delivery entities (i.e. physician organizations, physician hospital organizations, faculty groups, large independent groups, hospitals, etc.). Responsible to develop and maintain routine communications with such groups, performing presentations, education, and other activities to support the Plan’s provider service goals.

Qualifications

Qualifications:

Required:

  • Associate Degree in business, health care or related field.

  • Five (5) years’ experience in servicing hospitals and/or physician organizations and their office staff specific to Behavioral Health

  • Two (2) years’ experience and knowledge of HMO, PPO, TPA, PHO and Managed Care claims operations or provider billing functions

Preferred:

  • Bachelor’s Degree in business, health care or related field.

  • Established relationships with providers in the Plan’s service areas.

Job: Non-Health Professional

Primary Location: Indiana-Indianapolis-MDwise Inc

Employee Status Regular

Shift Day Job

Job Type Standard

Schedule Full-time

Req ID: 20008798

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