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Provider Relations Representative

BJC
Saint Louis, MO Full Time
POSTED ON 12/17/2024
AVAILABLE BEFORE 3/18/2025
Additional Information About the Role

Do you have experience with dealing with escalated insurance issues? BJC is looking for a Provider Relations Representative!

 

Remote Position (MO and IL only)

Monday - Friday 

Flex Schedule


Overview

BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3 billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice.

 

BJC is the largest provider of charity care, unreimbursed care and community benefits in the state of Missouri. BJC and its hospitals and health service organizations provide $785.9 million annually in community benefit. That includes $410.6 million in charity care and other financial assistance to patients to ensure medical care regardless of their ability to pay. In addition, BJC provides additional community benefits through commitments to research, emergency preparedness, regional health care safety net services, health literacy, community outreach and community health programs and regional economic development.

 

BJC’s patients have access to the latest advances in medical science and technology through a formal affiliation between Barnes-Jewish Hospital and St. Louis Children’s Hospital with the renowned Washington University School of Medicine, which consistently ranks among the top medical schools in the country.

 

The BJC Managed Care department includes multiple functions such as managed care contracting, financial analysis, systems and operations, value-based care and payment programs, payor and provider relations, and direct to employer solutions.


Preferred Qualifications

Role Purpose

Understands provider relationships and assists in activities that ensure the success of BJC providers in contract participation.

 

Responsibilities

  • Provides operational support to the department leadership.
  • Assists with financial research and analysis for BJC providers and care plans.
  • Coordinates and recommends communication between participating parties in regard to contracts and financial issues.
  • Coordinates internal and external education, meetings and seminars.
  • Conducts audits of provider compliance with contractual obligations.
  • Minimum Requirements

    Education

  • High School Diploma or GED
  • Experience

  • 2-5 years
  • Supervisor Experience

  • No Experience
  • Preferred Requirements

    Education

  • Associate's Degree
  • - Business

    Experience

  • 5-10 years

  • Benefits and Legal Statement

    BJC Total Rewards

    At BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.

    • Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date
    • Disability insurance* paid for by BJC
    • Pension Plan*/403(b) Plan funded by BJC
    • 401(k) plan with BJC match
    • Tuition Assistance available on first day
    • BJC Institute for Learning and Development
    • Health Care and Dependent Care Flexible Spending Accounts
    • Paid Time Off benefit combines vacation, sick days, holidays and personal time
    • Adoption assistance

    To learn more, go to www.bjctotalrewards.com/Benefits

    *Not all benefits apply to all jobs

    The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer

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