Provider Relations Contract Specialist - Req #1047

Company Description

Company Description
March Vision Care, Inc.

March Vision Care is a Knox Keene licensed, vision care plan managing and providing vision care programs for health plans, HMO’s and the business community; currently serving over 2.3 million members nationwide. We have a commitment to excellence for all facets of our vision benefit programs. March Vision Care’s mission is to be an active partner in improving health through high quality affordable vision care that focuses on early detection, education, and management through innovative, member-oriented solutions.



Job Description

Essential Duties & Responsibilities

  • Maintains visible accountability for all aspects of their assigned states, tasks and vendors.
  • Performs assigned tasks to implement new provider networks and to maintain necessary network access levels in accordance with internal and external performance standards.  These tasks include, but are not limited to; provider roster generation, provider roster review, provider roster distribution, provider add and change requests, provider portal technical support, provider Interactive Voice Response (IVR) support, provider mailings, provider contracting calls, provider record collection calls, and fax projects.
  • Collaborates with team members in the development of provider manuals, internal training manuals, and quarterly/ad-hoc provider newsletters to ensure MARCH policies are communicated accurately and professionally with respect to language choices and without misuse of spelling, grammar, or punctuation.
  • Collaborates with team members to maintain and improve department workflow and data capture procedures to ensure effective reporting and oversight abilities. 
  • Performs precise entry of provider and vendor information to ensure accurate provider rosters and overall data integrity.
  • Facilitates correction of provider and vendor information and collaborates with team members for the continuous evaluation of operational procedures to ensure ongoing process improvements.  Participates in the identification of problem origins and the development of tools and processes to eliminate and/or mitigate future occurrences of identified issues.
  • Participates in the successful implementation of new clients and product lines as they relate to network development, provider education, and network maintenance for their assigned states and vendors.
  • Communicates frequently with peers, team members and management on the performance of their assigned tasks.
  • Collaborates with team members in the creation of new policies, the need to eliminate unnecessary policies, and updates to existing policies as business needs change for their assigned states, vendors, and tasks.
  • Maintains provider, vendor, and other organizational relationships and leads projects as assigned by management.
  • Assists with the training of all department team members to ensure compliance with approved department and company policies.

Qualifications

Qualifications

  • High School Diploma or equivalent.  Bachelor degree preferred.
  • 1-3 years of customer relations or marketing experience or a related degree. OR 1-3 years managed care provider relations, claims, utilization management, provider education/publications or network development experience.
  • Basic knowledge of provider network development and maintenance preferred.
  • Basic knowledge of NCQA credentialing and recredentialing standards.
  • Basic level knowledge of MS Office products.
  • Basic level knowledge of report writing applications preferred.  Knowledge of Crystal Reports preferred.
  • Basic knowledge of Ingenix GeoAccess/GeoNetworks reporting tools preferred.

 

Additional Information

Do you possess the strategic, conceptual and creative thinking skills necessary to out-perform your job description? If you have an open mind and a true passion for our organization's mission and can execute numerous projects simultaneously under deadline pressure, MARCH VISION CARE offers the daily rewards and challenges associated with a fast-paced, cutting-edge organization. We offer a pleasant working environment and a competitive compensation/benefits package. Take advantage of a great location and pleasant team atmosphere that fosters creativity, where your input can have a profound effect. Are you ready to become a part of the MARCH success? For consideration please submit your resume to: [email protected]