Job Description

Who We Are:

Range Health is a healthcare organization focused on expanding access to high-quality, affordable health coverage and care in underserved markets. As part of a long-term growth strategy, Range Health is helping bring Medicare products and services to communities in Idaho and Montana, with opportunities for future expansion into additional markets and offerings.

We are seeking a Provider Relations Representative to act as a primary liaison between the organization and healthcare providers. In this independent role, you will maintain open communication regarding provider policies and payment procedures while training and education providers on our contact requirements and operational procedures.

Work Location: This position will be located in Montana

We are looking for a Provider Relations Rep with:

Provider Relations Rep I:

• Experience: 4 years' provider service or health industry experience
• Education: High School or equivalent

Provider Relations Rep II:

• Experience: 8 years' provider service or health industry experience
• Education: High School or equivalent

What your day may look like:

• Establish and maintain provider relationships for a new provider network in a new territory.
• Represent the company at association events and provide training education through provider meetings, presentations, webinars, virtual meetings and on-site visits.
• Coordinate the resolution of provider contracts, agreements, fee schedules, and payment problems.
• Collaborate with key stakeholders to identify and resolve issues.
• Coordinate resolution of contract or agreement issues. Communicate critical issues and provide recommendations to leaders.
• Educate providers on policies, procedures, practices, and data integrity.
• Coordinate cross departmental activities and projects to support and adhere to the provider contract requirements.
• Perform research to respond to inquiries and interpret policy and procedures to determine the most effective response.
• Provide welcome information to newly contracted providers and assist with on-boarding activities.
• Promote provider participation and utilization of on-line tools, provider resources and self – service programs.
• Perform other duties and responsibilities as assigned.

As of the date of this posting, a good faith estimate of the current pay range is $26.12 to 36.58 for a level I and $66,353 - $92,894 for a level II. The position is eligible for an annual incentive bonus (variable depending on company and employee performance).

The pay range for this position takes into account a wide range of factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, travel requirements, internal equity, business or organizational needs, and alignment with market data. At Blue Cross of Idaho, it is not typical for an individual to be hired at or near the top range for the position. Compensation decisions are dependent on factors and circumstances at the time of offer.

We offer a robust package of benefits including paid time off, paid holidays, community service and self-care days, medical/dental/vision/pharmacy insurance, 401(k) matching and non-contributory plan, life insurance, short and long term disability, education reimbursement, employee assistance plan (EAP), adoption assistance program and paid family leave program.

We will adhere to all relevant state and local laws concerning employee leave benefits, in line with our plans and policies.

Blue Cross of Idaho Health Service, Inc. is an independent licensee of the Blue Cross Blue Shield Association. For roles under Range Health, Ruby Analytics, or other non-licensed corporate entities: These services and products are managed or delivered by separate operating units or affiliates which are independent from, and not licensed by, the Blue Cross Blue Shield Association.

Reasonable accommodations

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.