Requisition 10000151

Professional Career Opportunities

Telephone Job Line: (214) 648-5627

PROVIDER RELATIONS REPRESENTATIVE

Posted Date Tue Sep 15, 2009

Closing Date Mon Sep 21, 2009 or until filled

Salary * Negotiable *

FLSA Status Exempt

Department Msrdp Business Operations Administration

Job Category Professional

Hours M-F 8-5

Requisition Number 10000151

Position Number 31646

Experience & Education Required (any one of the following):

1. Bachelor's degree in Health Care Administration, or equivalent, and three (3) years experience in areas of member service, provider relations, contract negotiations, claims and/or billing required.

Skills And Abilities Effective Communications Skills
Customer Service

Security This position is security-sensitive and subject to Texas Education Code §51.215, which authorizes UT Southwestern to obtain criminal history record information.

Job Duties 1. Acts as primiary contact to resolve issues between clinic faculty, staff and Managed Care Organizations (MCO). Tracks resolution of issues, the majority of which are related to claims and provider participation.

2. Conducts educational workshops for participating providers and staff to enhance their understanding of contracted managed care products, policies and procedures.

3. Gathers, reviews and verifies all pertinent information relating to assigned Managed Care Organizations. Ensures that any updates, changes, etc. that would impact UT Southwestern Medical Center (UTSWMC) faculty and staff are disseminated to appropriate personnel in a timely manner.

4. Ensures staff participation with all appropriate MCO's.

5. Works closely with other UTSWMC departments, Children's Medical Center (CMC), Parkland and the University Hospital personnel to resolve issues related to assigned MCO's.

6. Establish and maintain relatinship with assigned departments through office visits, telephone calls, prompt resolution of issues and excellend customer service.

7. Responsible for implementation of new Managed Care Organization contracts.

8. Provides various reports on request to Departments and Managed Care Companies.

9. Works closely with Managed Care Specialist to assist with more compliciated problems sent to the MCO Health Desk.

10. Proforms other duties as assigned.

Comments

Return to Professional Career Opportunities

Posted Date	Tue Sep 15, 2009
Closing Date	Mon Sep 21, 2009 or until filled
Salary	* Negotiable *
FLSA Status	Exempt
Department	Msrdp Business Operations Administration
Job Category	Professional
Hours	M-F 8-5
Requisition Number	10000151
Position Number	31646
Experience & Education Required (any one of the following):	1. Bachelor's degree in Health Care Administration, or equivalent, and three (3) years experience in areas of member service, provider relations, contract negotiations, claims and/or billing required.
Skills And Abilities	Effective Communications Skills Customer Service
Security	This position is security-sensitive and subject to Texas Education Code §51.215, which authorizes UT Southwestern to obtain criminal history record information.
Job Duties	1. Acts as primiary contact to resolve issues between clinic faculty, staff and Managed Care Organizations (MCO). Tracks resolution of issues, the majority of which are related to claims and provider participation. 2. Conducts educational workshops for participating providers and staff to enhance their understanding of contracted managed care products, policies and procedures. 3. Gathers, reviews and verifies all pertinent information relating to assigned Managed Care Organizations. Ensures that any updates, changes, etc. that would impact UT Southwestern Medical Center (UTSWMC) faculty and staff are disseminated to appropriate personnel in a timely manner. 4. Ensures staff participation with all appropriate MCO's. 5. Works closely with other UTSWMC departments, Children's Medical Center (CMC), Parkland and the University Hospital personnel to resolve issues related to assigned MCO's. 6. Establish and maintain relatinship with assigned departments through office visits, telephone calls, prompt resolution of issues and excellend customer service. 7. Responsible for implementation of new Managed Care Organization contracts. 8. Provides various reports on request to Departments and Managed Care Companies. 9. Works closely with Managed Care Specialist to assist with more compliciated problems sent to the MCO Health Desk. 10. Proforms other duties as assigned.
Comments