Provider Relations Representatives

Regal Medical Group is an affiliated Independent Physician Association ( IPA ) of Heritage Provider Network. At the forefront in the search for excellence in healthcare, we have developed a robust health care system that sets us apart from the other IPAs.

By combining the benefits of a well-managed and centralized administration function we are able to offer personal attention to our community-based physicians. Regal Medical Group and our physician network are committed to delivering high-quality medical care and improving patient service.

We are seeking a Provider Relations Rep for our Long Beach /Orange County Region.

 

The Provider Relations Regional Representatives are responsible for ensuring provider office compliance with all Regal Medical Group rules and regulations.
The coordinator will also:

¨  Provide new provider and staff orientation,

¨  Help resolve provider grievances and appeals in keeping with Regal contracts,

¨  Coordinate provider education,

¨  Ensure compliance with Regal contracts, as well as adhering to regulatory agencies such as DMHC, DHS, CMS, which are required by contracting HMOs.

¨  Conduct provider site audits,

¨  Audit database for accuracy,

¨  Ensure accurate and timely reporting requirements are being met,

¨  Provide other support to improve the performance of the business.

Requirements

¨  2-4 years managed care experience

¨  Knowledge of contracting principles/tools

¨  Excellent verbal and written communication skills

¨  Proficient in MS office programs (i.e., Word, Excel, Outlook, Access, and Power Point)

¨  Must be able to travel within service area and have valid driver’s license and insurance

 

We offer a full benefits package to all full time employees. Benefits include employer paid medical/dental (HMO) for our employees along with a generous PTO package and much more.

 

If you are interested in finding out more about this exciting career opportunity please forward your resume in word format to careers@regalmed.com or fax to (818) 357-5029.

Please visit our website at http://www.regalmed.com

No phone calls will be accepted .
Recruiters, please do not contact us.