Provider Relations Specialist- REMOTE

Posted 11 Days Ago
Be an Early Applicant
Hiring Remotely in Home, PA
Remote
59K-94K Annually
Junior
Insurance
The Role
The Provider Relations Specialist supports provider communication and education during client implementations and daily operations. Responsibilities include resolving provider inquiries, conducting outreach calls for prior authorizations, and participating in provider relations initiatives.
Summary Generated by Built In

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 Specialist- REMOTEJob Description

The Provider Relations Specialist is responsible for supporting the provider communication and education portion of new client implementations, and the ongoing daily support of the existing client networks of providers. This position is responsible for researching and resolving standard provider inquiries and technological challenges.

Responsibilities

  • Research and resolve provider inquiries in a timely manner.
  • Support or manage provider communication and education workgroups as needed to facilitate successful implementations of new health plans.
  • Conduct monthly outreach calls to provider offices utilizing phone or fax for prior authorization submissions and encourage web submissions as the preferred alternative
  • New user provisioning for provider portal with ongoing education and troubleshooting support
  • Participate as assigned to support provider relations initiatives.
  • Other duties as assigned

Education & Experience

  • Bachelor's degree in Business or related area of study, or equivalent combination of education and/or relevant work experience
  • 2 years of work experience in Provider relations and Medical pharmacy
  • Must be eligible to work in the United States without need for work visa or residency sponsorship

Additional Qualifications

  • Ability to work in a largely self-directed environment
  • Available for occasional overnight travel
  • Critical thinking skills and ability to anticipate issues and develop innovative solutions
  • Ability to manage competing priorities and deadlines
  • Experience working in provider relations
  • Proficient with Microsoft Office (Excel, Access, Word, PowerPoint)

Preferred Qualifications

  • Bachelor’s degree in Business Administration, Healthcare or related field

Physical Demands

  • Ability to work a flexible schedule including shifts outside of Prime's core business hours of 8:30 a.m. to 5 p.m. local time
  • Constantly required to sit, use hands to handle or feel, talk and hear
  • Frequently required to reach with hands and arms
  • Occasionally required to stand, walk and stoop, kneel, and crouch
  • Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
  • Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

Potential pay for this position ranges from $59,000.00 - $94,000.00 based on experience and skills.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail.

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.   

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Positions will be posted for a minimum of five consecutive workdays.

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The Company
HQ: Eagan, MN
3,577 Employees
On-site Workplace
Year Founded: 1987

What We Do

Everything we do is connected to helping people get the medicine they need to feel better and live well. It’s meaningful work and we’ve been doing it for over 20 years.

In the pharmacy benefit management (PBM)industry, we’re different. We’re owned by 18 not-for-profit Blue Cross and Blue Shield health plans. This allows us to control costs and empower our employees to put members first. It’s a successful combination. We have the lowest pharmacy trend in the industry and serve 28+ million members throughout the US.

In addition to core PBM services, we work closely with our clients to implement the right benefit design, clinical and specialty programs, formulary and networks. A few key products:
• NetResults™
• Specialty Drug Management
• Best in Care™
• GuidedHealth®
• Advanced Fraud, Waste and Abuse: Member and Prescriber Investigations
• Prime Analytics™
• CareCentered Contracting™Controlled Substance Management Program

Join us!
Prime is always looking for smart, purposeful people to join our team. We’re growing fast which means there are plenty of opportunities to advance and grow in your career.

At the same time, Prime supports flexibility and offers generous PTO so you can enjoy an enviable work/life balance. We’re a privately held company -big enough to make a difference and small enough for you to have an impact.

Follow Prime on LinkedIn to learn more.

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