Provider Management Specialist
Budget / Salary$51,000–53,000
TypeFull-time job
LocationUnited States
Posted3 hours ago
Staffing Solutions Organization LLC (SSO), an affiliate of Public Consulting Group LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed to a diverse workforce, which is a reflection of our clients and the people they serve.
Provider Management Specialist Location: Ohio Schedule: Full-Time Work Environment: Remote with Provider Site Visits as Required Position Summary The Provider Management Specialist I is responsible for supporting provider compliance, monitoring, and quality assurance activities. This position works directly with healthcare and community-based providers to assess compliance with applicable regulations, review documentation and business practices, conduct provider interviews, and identify opportunities for operational improvement. The successful candidate will possess strong analytical, communication, and customer service skills, along with the ability to work independently while maintaining positive provider relationships. Key Responsibilities Provider Relations & Customer Service
Build and maintain positive relationships with providers and stakeholders.
Serve as a professional point of contact for provider inquiries.
Deliver a high level of customer service through effective communication and responsiveness.
Coordinate and schedule provider site visits and compliance reviews.
Compliance Monitoring
Conduct provider compliance reviews in accordance with applicable regulations and program requirements.
Communicate review requirements and expectations to providers.
Conduct informational provider interviews.
Assess provider operations and business practices for compliance.
Documentation & Records Review
Review provider records and supporting documentation.
Collect documentation and evidence supporting compliance findings.
Convert hard-copy records into electronic formats for submission through web-based systems.
Maintain accurate and organized records of review activities.
Assessment & Reporting
Evaluate provider sites for compliance with oversight requirements.
Document and summarize compliance findings.
Identify trends involving non-compliance and operational deficiencies.
Provide timely recommendations to project leadership and management.
Assist with ongoing quality improvement initiatives.
Required Skills
Strong verbal and written communication skills.
Excellent customer service and relationship-building abilities.
Active listening and interviewing skills.
Strong attention to detail and accuracy.
Ability to analyze information and make sound recommendations.
Strong organizational and time-management skills.
Ability to work independently and collaboratively within a team environment.
Ability to prioritize multiple tasks and meet deadlines.
Process-oriented and results-driven approach to work.
Technical Skills
Microsoft Word
Microsoft Excel
Microsoft Outlook
Internet and web-based applications
Electronic documentation systems
Preferred Qualifications Education
Bachelor's degree in any field preferred.
Experience
Two (2) or more years of experience working with:
◦ Critical care providers ◦ Public health providers ◦ Providers serving children ◦ Providers serving older adults ◦ Providers serving individuals with traumatic brain injuries ◦ Providers serving individuals with developmental disabilities
• One (1) or more years of experience in:
◦ Provider monitoring ◦ Provider compliance ◦ Medicaid programs ◦ Third-party payer billing ◦ Provider education and training Work Environment
Professional environment.
Regular interaction with healthcare and community-based providers.
Periodic provider site visits may be required.
Independent and team-based work assignments.
Why Join SSO? SSO offers a competitive benefits package designed to support your health, financial well-being, and career growth, including:
Medical, Dental, and Vision Insurance
401(k) with Discretionary Employer Match
Paid Time Off and Holidays
Flexible Spending Accounts
Employee Assistance Program
Professional Development Opportunities
Additional Employee Perks
Compensation for roles at Staffing Solutions Organization LLC (SSO) varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, SSO provides a reasonable range of compensation for this role. In addition, SSO provides a range of benefits for this role.
Applicants must be authorized to work in the U.S. This position is not eligible for work authorization sponsorship (including H-1B sponsorship) by SSO and under the federal laws relating to the F-1 STEM EAD program, this position is not eligible to support a STEM EAD extension application.
All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability. Staffing Solutions Organization LLC is an E-Verify participant.
Originally posted on Himalayas
Provider Management Specialist Location: Ohio Schedule: Full-Time Work Environment: Remote with Provider Site Visits as Required Position Summary The Provider Management Specialist I is responsible for supporting provider compliance, monitoring, and quality assurance activities. This position works directly with healthcare and community-based providers to assess compliance with applicable regulations, review documentation and business practices, conduct provider interviews, and identify opportunities for operational improvement. The successful candidate will possess strong analytical, communication, and customer service skills, along with the ability to work independently while maintaining positive provider relationships. Key Responsibilities Provider Relations & Customer Service
Build and maintain positive relationships with providers and stakeholders.
Serve as a professional point of contact for provider inquiries.
Deliver a high level of customer service through effective communication and responsiveness.
Coordinate and schedule provider site visits and compliance reviews.
Compliance Monitoring
Conduct provider compliance reviews in accordance with applicable regulations and program requirements.
Communicate review requirements and expectations to providers.
Conduct informational provider interviews.
Assess provider operations and business practices for compliance.
Documentation & Records Review
Review provider records and supporting documentation.
Collect documentation and evidence supporting compliance findings.
Convert hard-copy records into electronic formats for submission through web-based systems.
Maintain accurate and organized records of review activities.
Assessment & Reporting
Evaluate provider sites for compliance with oversight requirements.
Document and summarize compliance findings.
Identify trends involving non-compliance and operational deficiencies.
Provide timely recommendations to project leadership and management.
Assist with ongoing quality improvement initiatives.
Required Skills
Strong verbal and written communication skills.
Excellent customer service and relationship-building abilities.
Active listening and interviewing skills.
Strong attention to detail and accuracy.
Ability to analyze information and make sound recommendations.
Strong organizational and time-management skills.
Ability to work independently and collaboratively within a team environment.
Ability to prioritize multiple tasks and meet deadlines.
Process-oriented and results-driven approach to work.
Technical Skills
Microsoft Word
Microsoft Excel
Microsoft Outlook
Internet and web-based applications
Electronic documentation systems
Preferred Qualifications Education
Bachelor's degree in any field preferred.
Experience
Two (2) or more years of experience working with:
◦ Critical care providers ◦ Public health providers ◦ Providers serving children ◦ Providers serving older adults ◦ Providers serving individuals with traumatic brain injuries ◦ Providers serving individuals with developmental disabilities
• One (1) or more years of experience in:
◦ Provider monitoring ◦ Provider compliance ◦ Medicaid programs ◦ Third-party payer billing ◦ Provider education and training Work Environment
Professional environment.
Regular interaction with healthcare and community-based providers.
Periodic provider site visits may be required.
Independent and team-based work assignments.
Why Join SSO? SSO offers a competitive benefits package designed to support your health, financial well-being, and career growth, including:
Medical, Dental, and Vision Insurance
401(k) with Discretionary Employer Match
Paid Time Off and Holidays
Flexible Spending Accounts
Employee Assistance Program
Professional Development Opportunities
Additional Employee Perks
Compensation for roles at Staffing Solutions Organization LLC (SSO) varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, SSO provides a reasonable range of compensation for this role. In addition, SSO provides a range of benefits for this role.
Applicants must be authorized to work in the U.S. This position is not eligible for work authorization sponsorship (including H-1B sponsorship) by SSO and under the federal laws relating to the F-1 STEM EAD program, this position is not eligible to support a STEM EAD extension application.
All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability. Staffing Solutions Organization LLC is an E-Verify participant.
Originally posted on Himalayas
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