Provider Relations Representative

Community Behavioral Health.

William Penn Annex West, PA

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JOB DETAILS

SALARY

$50,622–$58,000 Per Year

SKILLS

Analysis Skills, Behavioral Health, Billing, Business Administration, Calendar Management, Communication Skills, Community Health, Customer Support/Service, Disability Accommodations, Establish Priorities, Healthcare Administration, Insurance, Intrusion Detection Systems, Leadership, Legal, Licensing, Managed Care, Medicaid, Medicare, Meeting Minutes, Microsoft Office, Presentation/Verbal Skills, Problem Solving Skills, Provider Contracting, Provider Relations, Psychiatry and Mental Health, Safety Training, Team Player, Writing Skills

LOCATION

William Penn Annex West, PA

POSTED

1 day ago

Position Overview: The Provider Relations Representative acts as the CBH primary point person to CBH’s provider network for education, support and resolution of Provider inquiries. The Provider Relations Representative primarily fosters Community Behavioral Health’s ability to support, develop and maintain a collaborative and positive relationship with the Provider Network, through excellent customer service, in order to ensure that each Provider has continued success within the CBH Provider Network. Essential Functions : Responsible for cross-collaborating with multiple departments within CBH and as the most current source of knowledge for all assigned contracted Providers and Practitioners. Responsible for maintaining a repository of information for each of their assigned providers and practitioners. Oversee and maintain an assigned caseload of in-network Providers and Practitioners. The Representative will serve as a primary source of support and resource for their caseload, along with providing direction and assistance in resolving any emerging concerns as the Provider’s navigate the Department of Behavioral Health and Intellectual disAbility Services (DBHIDS). Ensures that all 4 components of DBHIDs (CBH as well as OMH, OAS (CODAAP), and IDS (MRS)) are able to retrieve information upon request regarding the provider/practitioner’s levels of care offered, locations, contact information, provider leadership, billing history, claims issues, and contract status (as needed). Delivers additional information internally as requested, by the Provider. Ensures Provider Network remains aware of all DBHIDs initiatives across all 4 components that are Provider related. Conduct site visits for all assigned CBH Providers regularly, unless the Provider Relations Representative participates in alternative regularly pre-scheduled CBH meetings at the Provider Site. Obtain Provider Capacity updates quarterly. More frequent updates, upon request. Provide coverage for Provider Hotline during normal business hours, as assigned. Participates in a multitude of meetings on behalf of their providers, to include but not limited to: Network Improvement and Accountability Collaborative (NIAC) prep meetings, compliance meetings, clinical provider meetings, provider teaming’s, claims and billing meetings, and executive level Provider Relations meetings with the CBH Chief Executive Officer (CEO). The Provider Relations Representative is responsible for gathering agenda items, taking meeting minutes and ensuring follow up occurs for the executive-level Provider meetings. Maintain provider agency licensing, insurance and rate information. Generate Schedule A (contract) change letters. Position Requirements: Education: Bachelor’s degree, preferably in a behavioral health/healthcare administration and/or business administration related field License/Certification: N/A Relevant Work Experience: Minimum of 3 years of equivalent experience, preferably in the mental health field, with knowledge of managed care and Medicaid/Medicare programs Skills: Proficiency in Microsoft Office Strong analytic and problem solving abilities Excellent verbal and written communication skills; ability to communicate with all levels of individuals Excellent customer service and networking skills Ability to organize and prioritize tasks Ability to work as part of a team Covid-19 Vaccine Requirement: The safety and well-being of our candidates, our people, and their families continues to be a top priority. Subject to applicable law, please be aware that CBH requires all employees to be fully vaccinated as a condition of employment. Equal Employment Opportunity: We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CBH is an equal opportunity employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on all qualified individuals. This is without regard to race, ethnicity, creed, color, religion, national origin, age, sex/gender, marital status, gender identity, sexual orientation, gender identity or expression, disability, protected veteran status, genetic information or any other characteristic protected individual genetic information, or non-disqualifying physical or mental handicap or disability in each aspect of the human resources function by applicable federal, state, or local law. Requesting An Accommodation: CBH is committed to providing equal employment opportunities for individuals with disabilities or religious observance, including reasonable accommodation when needed. If you are hired by CBH and require an accommodation to perform the essential functions of your role, you will be asked to participate in our accommodation process. Accommodations made to facilitate the recruiting process are not a guarantee of future or continued accommodation once hired. If you would like to be considered for employment opportunities with CBH and have accommodation needs for a disability or religious observance, please send us an email at CBH.Recruitment@Phila.gov Compensation details: 50622-58000 Yearly Salary PIe1b51d74b961-25448-410387275c143e31-5e48-4549-b638-05792d185386

About the Company

Community Behavioral Health.

Community Behavioral Health (CBH) is a not-for-profit 501c (3) corporation contracted by the City of Philadelphia to provide mental health and substance abuse services for Philadelphia County Medicaid recipients.

Supported through state funding, CBH works in partnership with the City of Philadelphia and the Commonwealth of Pennsylvania to provide vital behavioral health services. Today, CBH is responsible for providing behavioral health coverage for the City’s 420,000 Medicaid recipients. Its primary activities include:

Authorizing payment for behavioral health services
Requiring provider agencies to deliver effective and medically necessary services
Achieving management and operational efficiencies to lower healthcare costs

CBH is located in Philadelphia’s historic center city district. We offer competitive salaries and liberal benefit package, including:

403(b) with 8% company match
Medical HMO & HNO, Dental, Vision, and Pre ion Drug coverage, with low co-pays
Basic and Supplemental Life & AD&D
Generous paid time off, including holidays, vacation, personal and sick days
Long-Term Disability
Tuition Reimbursement
Employee Assistance Program
Transit Program
Company Wellness Program
Retiree Health Care

Most importantly, we offer an opportunity for dedicated professionals to have an immediate impact in the lives of the people we serve. Please review our web site at www.phila.gov/dbhids for more information about our company and to apply for positions.

COMPANY SIZE

100 to 499 employees

INDUSTRY

Healthcare Services

FOUNDED

1997

WEBSITE

http://www.phila.gov/dbhids

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