Providers Relationship Manager at a Leading Health Insurance Firm – Brasenwall Professional Consultants (3 Openings)

Job Title: Providers Relationship Manager

Specific Duities and Responsibilities

• Manage Business relationship with the existing and new providers.
• Expand the network of providers through accreditation.
• Conduct quality assurance through reaccreditation, claim audit, and clinical case review,
• Ensure the most accurate and timely contracts are in place including consideration of value based agreements.
• Building long term relationships with providers.
• Ensure quality assurance of providers.
• Conduct a well-care forum for clients and in-house provider training.
• Conduct prospective, concurrent and retrospective claims utilizations review.
• Conduct Case Management and providers auditing.
• Develop an effective working relationships and cooperation our providers.

Requirements

• Certificate: RN/BSN
• Experience: Five years with HMO experience.

Application Instructions:

The application deadline is Not Specified. Therefore, qualified and interested candidates should send their updated Resume to: [email protected] and copy: [email protected] using the Job Title as the subject of the email.

Note: Only qualified candidates will be contacted. It is important to visit the official website (link found below) for detailed information on how to apply successfully

Official Job Website: https://www.brasenwall.com/