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Company Name : Centivo
Location : Pittsburgh, PA
Position : Provider Relations Specialist
Job Description : We exist for American workers and their employers – who are the backbone of our economy. That is where Centivo comes in – our mission is to bring affordable, high-quality healthcare to the millions of Americans who struggle to pay their healthcare bills.Centivo is looking for a Provider Relations Specialist to join our team!As a Provider Relations Specialist, you will act as a primary resource for assigned providers and groups to establish, oversee, and maintain positive relationships by assisting with/or responding to complex issues regarding policies and procedures, plan design, contract language, service, claims or compensation issues, and provider education needs.What you’ll do: Working under guidance of the Director Provider Relations, you will: Coordinate outreach and ensure providers have smooth onboarding experiences as they join the Centivo network.EducateRe-educate providers as needed to ensure compliance with contract policies and parameters, plan design, compensation process, technology, policies, and procedures.Monitor service capabilities and collaborate cross-functionally to ensure that the needs of constituents are met and that escalated issues related but not limited to, claims payment, contract interpretation or parameters, and accuracy of provider contract or demographic information are resolved.Work with provider partners to ensure high quality and current provider data.Manage complex initiatives around contracting, data collection and validation, and provider credentialing.Support or assists with operational activities that may include, but are not limited to, database management, and contract coordination.Perform credentialing support activities as needed.You should have: 5+ years of relevant healthcare experiencePrior experience working with and interacting with healthcare providers and facilitiesUndergraduate degree or equivalent experienceAnd although it’s not required, we’d love it if you have negotiating experienceWho we are: Centivo is a new type of health plan for self-funded employers that is built to save 15 percent or more compared to traditional insurance carriers and is easy to use for employers and employees.Centivo’s mission is to bring lower cost, higher quality healthcare to the millions of working Americans who struggle to pay their healthcare bills. With Centivo, employers can offer their employees affordable and predictable costs, a high-tech member experience, exceptional service, and a range of benefit options including both traditional and proprietary networks. Centivo develops high-value networks in partnership with leading local healthcare providers and uses data analytics to refine the network and navigate members to the right providers. Members get a partner for all their healthcare needs through a primary care-centered model, as well as expanded access and fully integrated virtual care.With offices in New York City, Buffalo, NY and Denver, CO, Centivo is backed by leading investors including Bain Capital Ventures, Maverick Ventures, Bessemer Venture Partners, Ingleside Investors, Rand Capital, Company Ventures, and Oxeon Investments. Learn more at Centivo.com.Job Type: Full-timeWork Location: Remote
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