Provider Relations Representative

Umpqua HealthRoseburg, OR

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Job Description

Umpqua Health is a Coordinated Care Organization (CCO) in Roseburg, Oregon that connects over 40,000 Douglas County OHP members to physical, dental, and behavioral health services and benefits through an integrated network of providers. Umpqua Health is currently seeking a Provider Relations Representative to join our team. Provider Relations RepresentativeStatus: Full TimeSchedule: Monday - Friday 8:00-5:00PM Pacific Standard TimeSalary Range: (Wage Band 16) $54,000 - $65,000 (Salary is dependent upon skill, education, and experience)Location: Remote (Occasional travel to Roseburg or nearby locations)Total Rewards Package: Health, Dental, Vision, Life, 401K, Paid Time Off, Tuition Assistance, Fitness Reimbursement, and more!Must have reliable transportationPurpose:The purpose of the Provider Relations Representative is to support our provider network and drive excellence in care delivery by serving as a service-driven and relationship-oriented liaison between Umpqua Health and our healthcare providers. In this highly collaborative role, you will ensure that provider needs are met, concerns are addressed, and organizational standards are consistently upheld. Success in this position requires strong communication skills, keen attention to detail, and the ability to thrive in a dynamic and evolving healthcare environment.Qualifications:Minimum Qualifications

Bachelor’s degree in related field, or equivalent experience.
3 years of provider relations, healthcare administration, health plan operations, or related field.
Knowledge of health plan operations, Managed Care, Coordinated Care Organizations.
Advanced proficiency in Microsoft Office tools, capability to learn new software.
Proficiency in data collection, survey analysis and performance reporting.
Detail oriented, able to multitask and prioritize multiple competing deadlines.

Preferred Qualifications:

Project management experience.
Ability to work independently and take the lead on assigned projects.
Team players with a collaborative mindset and commitment to health equity and community care.
No suspension/exclusion/debarment from participation in federal health care programs (eg. Medicare/Medicaid)
Proficient computer skills, including MS Office suite
Experience considering the impacts of the work on multiple communities, including communities of color, in technical analysis.
Experience working on a diverse team
Experience working with different communication styles
Bi-lingual translation or translation capabilities a plus

Essential Duties:

Develop, implement and deliver provider training programs that promote high-quality, compliant care.
Be the direct contact for providers when issues arise, need education or resources, help navigate contract agreements.
Build and maintain positive working relationships with colleagues and provider personnel.
Coordinate and participate in community provider events.
Distribute notices and updates to the provider network. Answer questions and provide education.
Project work, as assigned.
Participate in internal and external audits as needed.
Communicate provider demographic information changes to appropriate personnel and ensure changes were made correctly.
Perform provider orientations and ongoing provider education, including onboarding and updating orientation materials.
Collaborate with internal stakeholders on process improvement initiatives focused on enhancing the providers’ ability to meet network standards and the overall provider experience.
Travel to off-site meetings and events as necessary.
Comply with organization’s internal policies and procedures, Code of Conduct, Compliance Plan, along with applicable Federal, State, and local regulations.
Perform other duties as assigned to support Umpqua Health’s Vision, Mission, and Organizational Values.

For more information or to apply visit our website at www.umpquahealthcareers.comUH is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. UH makes hiring decisions based solely on qualifications, merit, and business needs at the time. For more information, read through our EEO Policy.Drug-free Workplace:Umpqua Health is committed to providing a drug-free workplace for its employees and the communities it serves. This position requires successful completion of pre-employment screening which includes, but is not limited to; drug screen, criminal and federal background check, and other licensure requirement verifications.

About Umpqua Health

At Umpqua Health, we're more than just a healthcare organization; we're a community-driven Coordinated Care Organization (CCO) committed to improving the health and well-being of individuals and families throughout our region. Umpqua Health serves Douglas County, Oregon, where we prioritize personalized care and innovative solutions to meet the diverse needs of our members. Our comprehensive services include primary care, specialty care, behavioral health services, and care coordination to ensure our members receive holistic, integrated healthcare. Our collaborative approach fosters a supportive environment where every team member plays a vital role in our mission to provide accessible, high-quality healthcare services. From preventative care to managing chronic conditions, we're dedicated to empowering healthier lives and building a stronger, healthier community together. Join us in making a difference at Umpqua Health.

Umpqua Health is an equal opportunity employer that embraces individuals from all backgrounds. We prohibit discrimination and harassment of any kind, ensuring that all employment decisions are based on qualifications, merit, and the needs of the business. Our dedication to fairness and equality extends to all aspects of employment, including hiring, training, promotion, and compensation, without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, veteran status, or any other protected category under federal, state, or local law.

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