Regional Provider Access Manager
Regional Provider Access Manager
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Job Description
About Company
Samaritan Ministries is a Biblical solution to health care. It is not insurance. We deliver authentic compassionate and personal service in the name of Christ to enable and inspire members to provide for one anothers medical needs through prayer encouragement and financial support.
From demonstrating Christ-centered compassion to modeling best practices in health care sharing Samaritan Ministries is committed to keeping Jesus at the center of everything we do. The way we interact with our colleagues and engage with our members is a testament that we are ultimately serving Christ and His Kingdom.
Summary
To serve the members of Samaritan Ministries International (SMI) by acting as a liaison between members and healthcare providers. This role involves actively resolving existing provider issues and proactively building strong relationships with providers. The Provider Access Manager will create long-term relationships with providers engaging regularly with them to ensure that they are appropriately informed about Samaritans programs services and the latest guideline updates. Ultimately this role is responsible for SMIs reputation with providers in their assigned regions.
Competencies
- Acting with Integrity Empathy and Compassion
- Collaborating with Others
- Neighbor Focus
- Pursuing Excellence
- Managing Resources
- Problem Solving
- Planning and Organizing
- Attention to Detail
- Digital Literacy
- Negotiating
- Fostering Communication
Key Responsibilities
- Gather review and verify relevant information relating to participating providers.
- Educate providers on Redeem Program to streamline service for members with a focus on card acceptance.
- Work as a liaison for SMI by assisting with LOU compliance.
- Serve as the primary contact for existing and future agreements with provider.
- Facilitate direct agreements with critical providers and provider groups.
- Monitor mitigate and report member and provider abrasion related to cost containment vendors.
- Perform and/or administer research in ensuring effective timely responsiveness to all provider issues through an established escalation process.
- Be available for providers who wish to speak with SMI about questions or concerns that they have.
- Correspond through phone and email in a professional friendly and knowledgeable manner with health care providers and SMI members.
- Maintain current knowledge of SMI sharing programs program guidelines and processes.
- Provide Christ-centered encouragement and grace filled counsel to members and providers.
- Coordinate member and ministry business and workflows with various third-party vendors utilized by the ministry to serve members.
- Pray for members Providers and Vendors.
Qualifications and Experience
- Bachelors degree in a Healthcare or business-related field is preferred
- 3-5 years experience with healthcare networks/PPOs medical billing provider relations medical coding OR combination of education and experience required
- Knowledge ofSMI Programsand Guidelines
- Knowledge ofSMI Internal Policiesand Procedures (Intermediate) (particularly the needs processing and billing processes (Intermediate))
- Knowledge ofHealthcarecommon practices and terminology
- Negotiating techniques (Intermediate)
- Fair pricing calculations (Intermediate)
- Medical billing process (Intermediate)
- Single Case Agreements process
- Upfrontsharingloan processingin coordination with third party vendors
- Software: Microsoft (Intermediate) Office (especially Excel (Intermediate)) Hubspot Aircall Five9 Zoho Lessonly Call & E-mail recording software Gong
- Fair pricing tools(Intermediate) such asHCBB(Intermediate) Definitive Health (Intermediate) and AHD (Intermediate).
Additional Information
- Tasks are normally conducted in a regular office environment requiring use of computer and mouse and other standard office equipment. Staff usually remain in a stationary position often standing or sitting for prolonged periods. If remote/hybrid approved the employee must work in an appropriately professional and secure environment.
- Staff will observe safety principles while performing the duties of the position.
- May need to lift and move items up to 35 lbs on occasion.
- Staff will be required to travel (up to 25%) and have a valid drivers license.
- Disclaimer: This job description is intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be an exhaustive list of responsibilities duties and skills required of personnel in the classification. Work hours are standard during the workweek (Monday - Friday) with potential but rare need for evening or weekend work.
- This position requires an active commitment to the mission and values of the course of performing job duties the employee will act in a manner that is Christ-honoring as well as Christ-like demonstrating a personal Christian faith and witness in all interpersonal interactions.
- Performance-based incentive pay
- SMI Membership with monthly healthcare bonus
- Health Insurance: MEC plan with employer HSA contribution
- 401K Retirement plan with employer contribution
- Life Insurance
- Short-term disability
- Dependent Care Flexible Spending Account
- Time Off: 9 company paid holidays 5 missions days accrued annually maternity and paternity leave FMLA Bereavement and weekly accrued PTO(40 hours to use after 30 days 80 hours accrued for 48 weeks)
- Health club or home workout benefits for participating staff
- Formal staff development and leadership training
- Spiritual support and counseling through our staff support office
- Repeatedly certified as a Best Christian Workplace
Required Experience:
Manager
Employment Type
Full Time
