Posted: Friday, February 9, 2018 1:15 AM
For more than 80 years, Blue Cross and Blue Shield of Minnesota has been passionate about improving health. We provide quality, cost:effective health plans and innovative programs that make a healthy difference in people's lives. Blue Cross is the largest health plan based in Minnesota, covering nearly 3 million members in the state and across the country. We strive to help all Minnesotans overcome the barriers to good health.
We offer our employees a comprehensive benefits, compensation and total rewards package to keep you and your family healthy and to secure your financial future. Our Employee Resource Groups help us advance health equity while promoting a diverse and inclusive work environment. Join us and make a healthy difference in people's lives through the work you do every day. Together, well make Minnesota a better place to live - and a healthier one.
Description Summary 13;
This position is responsible for managing the business relationship between Blue Cross and designated providers. This includes effectively analyzing, organizing, developing and implementing service and system solutions, which improve costs and efficiency for both providers and Blue Cross. 13;
: Develops and maintains positive business to business relationships with providers through meetings, phone work or email. This includes understanding and documenting market intelligence.
:Organize, prepare and facilitate provider meetings including creating agendas, maintaining issue logs and documenting appropriate information in NMC tools.
:Performs internal facilitation for the following provider issues: contract implementation, data updates, termination, referral process, health benefit products, EC setup, reports etc as needed.
:Identifies, facilitates and resolves complex service issues on a consistent basis by utilizing appropriate internal resources and asking appropriate questions in order to bring the issue to closure to the satisfaction of provider and Blue Cross.
:Identifies global issues affecting providers on a consistent basis, brings forward issues to team and consistently keeps up maintenance on the log.
:Consistently provides education to providers on self:help options/coding policies/new BlueCross programs etc.
:Works effectively with team, other internal departments, attends committee meetings on behalf of team and establishes consistency in following up on internal requests/projects
:Has (or will develop) working knowledge of provider contracts, is able to address contract questions and fee schedule information on a regular basis and report potential issues to negotiator as needed.
:Bachelors degree and 3 years of related work experience required, or 7 years of related work experience in lieu of a degree.
:Familiarity with Microsoft Office products including: Word, Excel, Access Enhanced customer service skills Time Management skills.
:Some research skills necessary.
Preferred Requirements 13;
:Baseline knowledge of STAR, PAandR, IMS or other internal systems preferred.
FLSA Status 13;
Blue Cross Blue Shield of Minnesota is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, or any other legally protected characteristic.
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Thank you for your interest in Blue Cross. Be part of a company that lets you be you - and make a healthy difference in people's lives every day
Blue Cross is an Equal Opportunity and Affirmative Actio
• Location: eagan, Minneapolis / St. paul
• Post ID: 29297787 minneapolis