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Provider Relations Representative

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Date: Jun 6, 2019

Location: Portland, ME, US

Company: NTT DATA Services

Req ID: 49531 

 

At NTT DATA Services, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our company’s growth, market presence and our ability to help our clients stay a step ahead of the competition. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA Services and for the people who work here.

 

NTT DATA Services currently seeks a Provider Relations Representative to join our team in Portland, Maine (US-ME), United States (US).

 

 

In these roles you will be responsible for:

  • Acts as primary liaison with the Healthcare provider network.
  • Participates, organizes and manages workbooks for provider operational meetings.
  • Monitors corrective action plans and manages the implementation of plan(s) collaboratively within HPHC.
  • Addresses escalated issues and problems affecting provider reimbursements.
  • Must identify and negotiate mutually beneficial resolutions to escalated issues and problems.
  • Coordinate and present to large/small groups, societies, associations and industry groups to represent HPHC.
  • Work collaboratively with Network Operations, Network Contracting, Network Medical Management, Care Management, Sales, Policy, Reimbursement, Member Services and other departments for issue resolution.
  • Demonstrate a thorough understanding of network providers’ contractual and reimbursement arrangements.
  • Is conversant with contractual terms of all provider types (i.e., physician, hospital and ancillary) in the HPHC provider network.
  • Clear understanding of claim submission and processing.
  • Communicates to internal constituents regarding critical issues that impact the providers’ overall performance and satisfaction.
  • Consultant is skilled at determining when issues are not being effectively resolved and appropriately elevates issues to management as needed.
  • Requires travel between client locations, provider offices, hospitals and professional trade associations as warranted.

Requirements for this role include:

  • Bachelor’s Degree in Business Administration or related field required.
  • 5+ years’ experience in the business system analysis industry.
  • Prior experience in a health care setting
  • Willingness to work in a collaborative environment
  • Excellent communication, training and speaking skills
  • Highly organized with ability to give and take direction as necessary

 

 

This position is only available to those interested in direct staff employment opportunities with NTT DATA, Inc. or its subsidiaries.  Please note, 1099 or corp-2-corp contractors or the equivalent will NOT be considered. We offer a full comprehensive benefits package that starts from your first day of employment.                                                                                

                     

About NTT DATA Services

 

NTT DATA Services partners with clients to navigate and simplify the modern complexities of business and technology, delivering the insights, solutions and outcomes that matter most. We deliver tangible business results by combining deep industry expertise with applied innovations in digital, cloud and automation across a comprehensive portfolio of consulting, applications, infrastructure and business process services.

 

NTT DATA Services, headquartered in Plano, Texas, is a division of NTT DATA Corporation, a top 10 global business and IT services provider with 118,000+ professionals in more than 50 countries, and NTT Group, a partner to 88 percent of the Fortune 100. Visit nttdataservices.com to learn more.

 

NTT DATA, Inc. (the “Company”) is an equal opportunity employer and makes employment decisions on the basis of merit and business needs.  The Company will consider all qualified applicants for employment without regard to race, color, religious creed, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other class protected by law.  To comply with applicable laws ensuring equal employment opportunities to qualified individuals with a disability, the Company will make reasonable accommodations for the known physical or mental limitations of an otherwise qualified individual with a disability who is an applicant or an employee unless undue hardship to the Company would result.

 

 

 


Nearest Major Market: Portland Maine

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