Provider Relations Specialist II

For over 30 years, HMA has been the premier third-party health plan administrator in the PNW. We relentlessly deliver on our promise to provide employers with customized health insurance plans, for their Staff, that offer high-quality healthcare, at a reasonable cost, with first-rate customer service support. In 2021 AND 2022, HMA was chosen as a Washington's Best Workplaces by our Staff and PSBJ™. Our vision, 'Proving What's Possible in Healthcare™,' and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results.What we are looking for: We are looking to hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team and helping others succeed, are motivated by tackling complex challenges, are courageous enough to share ideas, are action-oriented, are resilient, and are results-driven. What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, benefits, and time off packages with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: https://www.accesshma.com/How YOU will make a Difference: As the Provider Relations Specialist, you will support and Manage strong relationships with Providers, building effective partnerships to better serve our Clients. What YOU will do:

• Networker and relationship builder: supports and manages strong relationships and issue resolution with HMA Providers.
• Report analysis and management: Oversees and supports escalated Provider issues to resolution.
• Analyzes data (appeals, CRM tasks, payment integrity performance trends, denial trends), proactively assesses issues to provide the best customer service while practicing fiscal responsibility.
• Business subject matter expertise: Understands and brings industry perspective to HMA Operations.
• Independent decision making: Ability to identify and resolve team issues and escalates appropriately any corporate wide impacts.
• Oversees escalated issues: Proactively guides the team to adjust as needed to accelerate issue resolution and properly escalate and document outcomes.
• Promote understanding of HMA payment Integrity programs within the Provider community to minimize abrasion.
• Promote understanding of HMA tribal programs within the Provider community to minimize abrasion.
• Meeting facilitation skills: Create agendas and meeting objectives based on project and program statuses and effectively facilitate meeting content.
• Creates external communications that are professional and promote HMA values.
• Manage provider disruption communications, both internal and external and assess impacts.
• Set and maintain regular meetings with top tier Providers to strong relationships and open lines of communication.
• Primary liaison with Network Provider Relations Department including escalations, Regence changes and processes.
• Understand Provider technology developments and represent projects and evolution of business requirements within the organization.
• Represent the Provider experience related to HMA tools such as Echo and Availity.
• Support of issues related to network adequacy.
• Operational support of Provider Direct contracts.

Knowledge, Experience, and Key Attributes needed for Success:

• Bachelor's degree or equivalent preferred
• 3-5 years of Provider Relations experience
• 3-5 years of clearing house software experience such as Availity
• Experience building and managing productive relationships externally such as partners, vendors, or clients
• Must be a critical thinker and very analytical in order to synthesize data and troubleshoot issues
• Great communication skills in order to interact with internal and external stakeholders
• Strong organizational savvy and business acumen

How we Support your Work, Life, and Wellness Goals We offer a comprehensive total rewards package including: competitive pay; annual incentive; medical, dental, and vision insurance; 401K retirement plan with match; generous PTO and holidays; an onsite gym facility; a gym subsidy; Life, AD&D, Short-Term and Long-Term Disability Insurances; an Employee Assistance Plan; free parking and easy freeway access to I-405 and I-520; a well-stocked kitchen on-site with subsidized snacks and refreshments; year-round wellness activities; the ability to earn a $500 wellness incentive; monthly events; paid volunteer hours and more! HMA requires a background screen prior to employment. Compensation:The base salary range for this position in the greater Seattle area is $67,814-$86,188 and varies dependent on geography, skills, experience, education, and other job or market-related factors. While we are looking for level II, we may consider level III for highly qualified candidates with a base salary range of $77,944-$98,749. Performance-based incentive bonus(es) is available. In addition, HMA provides a generous total rewards package that includes: seventeen days paid time off; eleven paid holidays, one paid personal and one paid volunteer day; company-subsidized medical, dental, vision, and prescription insurance; company-paid disability, life, and AD&D insurances; voluntary life insurances; HSA and FSA pre-tax programs; 401(k)-retirement plan with company match; wellness incentive and reimbursement; remote work and continuing education reimbursements; discount program; parental leave; and a charitable giving match. For more information about HMA, visit www.accesshma.com.Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law.Protected Health Information (PHI) Access Healthcare Management Administrators (HMA) employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA's standard policies and procedures. HMA is an Equal Opportunity Employer