Provider Engagement Professional 2

About the role

Manage day to day relationships with physical and behavioural health providers in a state Medicaid network, supporting onboarding, education and issue resolution. The role aims to improve financial and quality performance within contracted relationships.

What you will do

• Act as main relationship contact for assigned providers and promote network retention
• Run in person and virtual trainings, including required annual sessions
• Onboard new providers with orientation and explain policies and systems
• Resolve provider questions on claims payment, prior authorisations and referrals
• Convene service operating committee meetings and coordinate regional townhalls
• Ensure contractual provider relations requirements such as timely claims dispute resolution

What they look for

• Two or more years in healthcare or managed care working with providers
• Knowledge of claims systems, adjudication, submission, coding or dispute resolution
• Residence in Oklahoma
• Willingness to travel frequently, up to half of the time daily

Nice to have

• Bachelor degree
• Oklahoma Medicaid experience
• Work with behavioural health providers, facilities or FQHCs
• Understanding of provider contracts, credentialing and reimbursement language