Provider Relations Representative

Salary Range for Provider Relations Representative in Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds

Salary range for the position of Provider Relations Representative in Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds typically falls between $45,000 and $65,000 per year.

Sample Job Description for Provider Relations Representative in Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds Industry

Job Description:

A Provider Relations Representative Plays A Crucial Role In Maintaining Positive Relationships Between The Pharmacy Benefit Management (Pbm) Company And Healthcare Providers. They Are Responsible For Ensuring That Contracted Healthcare Providers Understand And Adhere To The Terms And Conditions Of Their Agreements With The Pbm. The Primary Objective Of This Role Is To Enhance Provider Satisfaction And Promote Effective Collaboration.

Job Requirements:

1. Bachelor'S Degree In Healthcare Administration, Business, Or A Related Field. 2. Knowledge Of Pharmacy Benefit Management And Third-Party Administration Of Insurance And Pension Funds. 3. Strong Understanding Of Healthcare Industry Regulations And Compliance. 4. Excellent Interpersonal And Communication Skills. 5. Ability To Build And Maintain Relationships With Healthcare Providers. 6. Proficient In Data Analysis And Reporting. 7. Detail-Oriented With Excellent Organizational Skills. 8. Ability To Multitask And Prioritize Tasks Effectively. 9. Strong Problem-Solving And Decision-Making Abilities. 10. Knowledge Of Medical Coding And Billing Practices.

Job Responsibilities:

1. Act As The Primary Point Of Contact For Healthcare Providers. 2. Establish And Maintain Positive Relationships With Contracted Providers. 3. Educate Providers On Pbm Policies, Procedures, And Contractual Obligations. 4. Monitor Provider Performance And Address Any Issues Or Concerns. 5. Collaborate With Internal Teams To Resolve Provider-Related Issues. 6. Conduct Regular Provider Meetings To Discuss Performance Metrics And Identify Areas For Improvement. 7. Analyze Provider Data And Generate Reports To Evaluate Performance. 8. Ensure Compliance With Regulatory Requirements And Contractual Obligations. 9. Coordinate With The Contracting Team To Negotiate And Renew Provider Contracts. 10. Stay Updated On Industry Trends And Changes In Regulations Affecting Provider Relations.

Top 10 Employers for Provider Relations Representative in Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds:

1. Express Scripts - Headquarters: St. Louis, MO, USA - Website: www.express-scripts.com 2. CVS Health - Headquarters: Woonsocket, RI, USA - Website: www.cvshealth.com 3. OptumRx - Headquarters: Eden Prairie, MN, USA - Website: www.optumrx.com 4. Cigna - Headquarters: Bloomfield, CT, USA - Website: www.cigna.com 5. Humana - Headquarters: Louisville, KY, USA - Website: www.humana.com 6. Anthem, Inc. - Headquarters: Indianapolis, IN, USA - Website: www.anthem.com 7. Magellan Health - Headquarters: Scottsdale, AZ, USA - Website: www.magellanhealth.com 8. Prime Therapeutics - Headquarters: Eagan, MN, USA - Website: www.primetherapeutics.com 9. UnitedHealth Group - Headquarters: Minnetonka, MN, USA - Website: www.unitedhealthgroup.com 10. Aetna - Headquarters: Hartford, CT, USA - Website: www.aetna.com

Career Path for Provider Relations Representative in Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds:

1. Entry-level positions in healthcare administration or customer service - 2-3 years. 2. Provider Relations Coordinator - 3-5 years. 3. Provider Relations Specialist - 5-7 years. 4. Provider Relations Manager - 7-10 years. 5. Provider Relations Director - 10+ years. Recommended education: Bachelor's degree in healthcare administration or a related field.

Top 5 Countries by Provider Relations Representative in Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds:

1. United States 2. Canada 3. United Kingdom 4. Australia 5. Germany

Top 5 Countries with Established Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds:

1. United States 2. Canada 3. United Kingdom 4. Germany 5. Australia