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Provider Relations Rep - Paramount - Full Time - Days

Cincinnati, Ohio; Columbus, Ohio
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Description

For more than 30 years, Paramount, ProMedica’s health plan, has offered health insurance products across six Midwest states. Paramount is an Ohio-based health insurance company, headquartered in Maumee. Our team of more than 800 employees is dedicated to serving our health plan members.

Paramount offers Medicare Advantage, Medicaid managed care and Marketplace Exchange health plans for individuals and families. We maintain accreditation by the National Committee for Quality Assurance (NCQA) for our HMO, Medicare Advantage and Medicaid products.

We also offer a full complement of insurance products for employers of any size, including medical, dental, vision and workers’ compensation as well as vocational rehabilitation, life-care planning and wellness.

As a part of ProMedica, we are driven by our Mission to improve your health and well-being. ProMedica is ranked the second most integrated health system in the U.S. and No. 1 in the Midwest. At Paramount, we strive to provide an exceptional experience to every member. For more information about Paramount, please visit our website.

Position Summary

Manages provider communications and various reports generated by the Provider Relations Department to meet corporate and regulatory requirements. Provide support for the Provider Relations Department including the Manager of Provider Relations and Provider Relations Representatives.

Accountabilities 

1. Develop and maintain internal and external communications for the Provider Relations department, including bulletins, flyers, forms, manuals and presentations. Coordinate with other departments such as Marketing and Communications to support communications both internally and with the provider community.

2. Manage Provider Relations communications to the provider community.

3. Coordinate with vendors as required for the Provider and Office Manager Satisfaction Surveys, along with the secret shopper surveys and other surveys as required.

4. Develop reports as required such as the Provider Access and Availability Report.

5. Work with Provider Relations staff and with other departments to develop and maintain Provider Relations department policies and procedures to conform with Paramount and

6. Work with other departments to perform duties as assigned to support the overall operations of the Provider Relations department and Paramount as a whole

7. Support Provider Relations field representatives by managing and allocating communications coming into the department via email, website, fax and telephone and by coordinating as needed with Claims, Contracting and other departments to investigate and resolve claims and other issues from providers.

8. Coordinate projects assigned to the Provider Relations department to support other areas of Paramount as well as perform other duties as needed to support the overall operations of the Provider Relations Department.


REQUIRED QUALIFICATIONS
Education: Associates degree in lieu of experience
Skills: Demonstrated experience in Microsoft Applications required. Excellent written and oral communications skills required.
Years of Experience: 3-5 years relevant experience in lieu of associates degree
 

PREFERRED QUALIFICATIONS
Skills: Excellent organizational skills, ability to work independently and demonstrated attention to detail.

 

ProMedica is a mission-based, not-for-profit integrated healthcare organization headquartered in Toledo, Ohio.  For more information, please visit www.promedica.org/about-promedica

Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact employment@promedica.org

Equal Opportunity Employer/Drug-Free Workplace
 

 

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