Provider Relations Representative

Acts as the primary point of contact for CBH’s provider network, providing education, support, and resolution of provider inquiries. Fosters a collaborative and positive relationship with the provider network through excellent customer service to ensure continued success within the CBH Provider Network.

Responsibilities

• Cross-collaborate with multiple CBH departments as the most current source of knowledge for assigned contracted providers and practitioners.
• Maintain a repository of information for each assigned provider and practitioner.
• Oversee and maintain an assigned caseload of in-network providers and practitioners, serving as their primary source of support and resource.
• Provide direction and assistance in resolving emerging concerns as providers navigate the Department of Behavioral Health and Intellectual disAbility Services (DBHIDS).
• Ensure all four DBHIDS components (CBH, OMH, OAS (CODAAP), and IDS (MRS)) can retrieve provider/practitioner information upon request, including levels of care offered, locations, contact information, leadership, billing history, claims issues, and contract status.
• Deliver additional provider-requested information internally as needed.
• Keep the provider network informed of all DBHIDS initiatives across all four components that are provider-related.
• Conduct regular site visits for assigned CBH providers or participate in alternative pre-scheduled CBH meetings at provider sites.
• Obtain provider capacity updates quarterly, or more frequently upon request.
• Provide coverage for the Provider Hotline during normal business hours, as assigned.
• Participate in meetings on behalf of providers, including but not limited to: Network Improvement and Accountability Collaborative (NIAC) prep meetings, compliance meetings, clinical provider meetings, provider teaming sessions, claims and billing meetings, and executive-level Provider Relations meetings with the CBH CEO.
• Gather agenda items, take meeting minutes, and ensure follow-up for executive-level provider meetings.
• Maintain provider agency licensing, insurance, and rate information.
• Generate Schedule A (contract) change letters.

Requirements

• Bachelor’s degree, preferably in behavioral health/healthcare administration, business administration, or a related field.
• 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.

Pay

$50,622–$58,000 yearly salary.