Provider Relations Representative

Silicon Valley Medical Development is currently seeking a talented Provider Relations Representative to join our growing healthcare team!

Pay: $84,000-$120,000/ Annually 

Location: Santa Clara County locations 

Shift: 8am-5pm 
 

Silicon Valley Medical Development, (SVMD) LLC is a growing provider organization with community-based ambulatory care clinics and medical practices in Santa Clara County.

SVMD seeks to coordinate care that best fits the needs of the communities we serve, with like-minded people who want to simplify the healthcare experience. With a commitment to teamwork and quality, together we can offer exceptional care to our patients.

The Provider Relations Representative is responsible for building long-term relationships with delegated partners, clinics, and provider groups to support their understanding and compliance with the organization's contracts, policies, and procedures.

Essential Functions: 

The Provider Network Associate will serve as a liaison to Silicon Valley Medical Developments (SVMDs) network of provider clinics within The Provider Network Associate will be an integral part of the Provider Network Management and provide exemplary customer service and training to all providers in compliance with all applicable state and federal regulatory requirements, SVMD policies and procedures, and business requirements.

• Identify and research issues related to provider contracting, compliance, and operational issues using various sources.
• Oversee major Provider Relations projects, including organization, planning, delegation of tasks, and communication with providers.
• Prepare and deliver verbal presentations to Silicon Valley Medical Development Network Providers and their staff.
• Act as the primary trainer for new members of the Provider Relations team.
• Schedule and perform provider outreach visits, trainings, and orientation sessions.
• Collaborate with other department leaders to coordinate resolution of operational issues with internal departments and cross-departmental improvement efforts.
• Build and maintain expertise and understanding of managed care, SVMD policies and procedures and relevant regulatory requirements. Incorporate knowledge into the development of provider training and communication tools to improve compliance.
• Initiate and manage process improvement projects in response to identified complex operational issues, trends, or regulatory changes.
• Perform other related duties as required or assigned.

Minimum Requirements:

• Bachelor's Degree in any field or equivalent experience
• Five years of job experience in provider services for a Medi-Cal managed care health plan or related healthcare environment preferred
• Strong verbal and written communications, and active listening skills
• Strong interpersonal, organizational, analytical, and critical problem-solving skills.
• Develop and maintain strong internal and external working relationships.
• Knowledge of Medi-Cal managed care and provider services responsibilities in a managed care setting.
• Customer service oriented and resourceful
• Ability to effectively organize and prioritize task in order to complete assignments within the time allotted to maintain standard workflow
• Ability to work effectively as a team member who is flexible, cooperative, and willing to assist others

Preferred:

• EPIC EMR experience