Tampa, Florida
Provider Relations Asstant Job Opening in Tampa, Florida - About Quality Health Plans of New York, Inc. Quality Health Plans of New York, Inc. (?QHPNY?) is a Medicare Advantage HMO committed to providing our members the highest caliber, most effective and innovative programs in the healthcare industry. QHPNY is the fastest growing MAPD, HMO Plan on Long Island. In order to accomplish this, we have gathered substantial input from the local provider community, and seek to preserve the independence of the physician-patient relationship in determining medical care.
Our style of management empowers primary care physicians to use their professional experience to coordinate and ensure the best possible care for each patient. In other words, QHPNY allows its team of dedicated physicians and healthcare professionals to focus on what is most important: providing exceptional quality care and achieving high levels of patient satisfaction.
What We Do Quality Health Plans of New York's healthcare model allows the primary care physician to schedule each patient as frequently as needed so that the patient?s care is closely monitored. Patients may schedule visits more frequently, and our research indicates that 20 percent will do so. Specialist visits and services are also coordinated through the patient?s primary doctor.
QHPNY delivers a broad range of comprehensive health services, and we ensure that our patients have access to all covered Medicare benefits. Contracted physicians and healthcare providers are expected to be available 24 hours a day, seven days a week, whether it is during office hours, after hours or via service coverage. Patients in and out of the defined service area may also access hospital emergency room services 24 hours a day, seven days a week for urgent/emergent care.
Commitment to Quality QHPNY believes that quality healthcare starts with the provider-patient relationship. We carefully offer contracting opportunities to the highest caliber of physicians and hospitals. In addition, we have a formal Quality Assurance Team that monitors the quality of our network and is committed to bringing quality, affordable, convenient, and easy-to-use healthcare to all of our additional information please visit our website:
Provider Relations Representatives:
Position Location: Tampa, FL
QHPNY?s Provider Relations Representatives provide a key role in creating and managing the bond that QHPNY builds with their providers. Among the personal job satisfaction that is received due to the steady involvement with providers, QHPNY also offers competitive compensation and employee benefits which consist of:
Medical ? QHPNY pays a portion of the coverage.
Dental and Vision Coverage
Life Insurance
Short Term and Long Term Disability
401(k) Retirement Plan inclusive of Company Match
Paid Time Off
Career Path Opportunities
Provider Relations Representatives assist providers primarily currently located in Nassau, Suffolk, Queens and Richmond Counties. Provider Relations Reps. are responsible for visiting and assisting existing providers with any questions or concerns they may have. Contracting with additional providers is also one of the main responsibilities.
Additional Responsibilities:
Assist with provider contracts
Assist with delegation audits
Prepare provider membership disks/letters
Review and prepare case rates/Letter of Agreement
Ensure provider directories are updated in a timely and accurate manner
Complete Provider Site Survey?s
Provider training and Education
Qualifications:
Strong knowledge and experience within the healthcare insurance industry
Minimum of two years experience with manged Medicare contracting and credentialing
Strong follow-up, negotiating an influencing skills
Able to manage multiple complex issues in a fast paced environment
Familiar with claims processing
Strong oral and written communication skills, and computer skills
Knowledge of MS Word and Excel preferred.
Ability to maintain a professional demeanor at all times
Detailed Orientated
Must be able to travel
For an opportunity to join the QHPNY team please submit your resume and salary requirements online.
Job Type: Full-time
Required education:
Associate
Required experience:
Medicare manage care contracting and credentialing: 2 years
Healthcare Industry: 2 years
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