Provider Support Specialist
Remote-Position--
-
This is a remote position in which we are able to employ in the following states: Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin
-
JOB SUMMARY/PURPOSE
-
Acts as an advocate for providers. Ensures that providers support and remain educated regarding Samaritan Health Plans procedures, benefits, available provider tools and policies. Works with providers in a variety of areas (e.g. medical, mental health, oral health, prescription drug). Works alongside providers to troubleshoot problems that they are experiencing. Brings the provider prospective back to the Health Plan for consideration of enhancement to available tools and related provider projects.
-
DEPARTMENT DESCRIPTION
-
Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services’ self-funded employee health benefit plan. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.
-
EXPERIENCE/EDUCATION/QUALIFICATIONS
-
Bachelor’s degree or equivalent relevant experience in the health care industry required.
-
Experience or training with MS Office required.
-
Health Plan experience strongly preferred, especially in the areas of member services, provider relations, training, education, referral authorization, provider maintenance and/or claims processing.
-
KNOWLEDGE/SKILLS/ABILITIES
-
Effective written and verbal communication skills to perform group presentations, tactfully discuss issues, and listen to and understand concepts, rules and procedures. Ability to work with all levels within the organization, facilitate communication, and effectively document related activities.
-
Ability to identify complex problems, review related information, employ creativity and alternative thinking to develop and evaluate options and implement solutions.
-
PHYSICAL DEMANDS
-
Rarely
(1 - 10% of the time)
Occasionally
(11 - 33% of the time)
Frequently
(34 - 66% of the time)
Continually
(67 – 100% of the time)
CLIMB - STAIRS
LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs
LIFT (Knee to chest: 24"-54") 0 – 20 Lbs
LIFT (Waist to Eye: up to 54") 0 - 20 Lbs
CARRY 1-handed, 0 - 20 pounds
BEND FORWARD at waist
KNEEL (on knees)
STAND
WALK – LEVEL SURFACE
ROTATE TRUNK Standing
REACH - Upward
PUSH (0 - 20 pounds force)
PULL (0 - 20 pounds force)
SIT
CARRY 2-handed, 0 - 20 pounds
ROTATE TRUNK Sitting
REACH - Forward
MANUAL DEXTERITY Hands/wrists
FINGER DEXTERITY
PINCH Fingers
GRASP Hand/Fist
PI276196242
