Provider Relations Specialist

At Carolina Complete Health Network (CCHN), the Provider Relations Specialist primarily focuses on strengthening relationships with Medicaid and Marketplace providers. Key responsibilities include serving as the main contact for operational inquiries, resolving provider issues, educating them on CCHN processes, and facilitating contract negotiations. The specialist acts as a liaison between providers, health plans, and internal teams, ensuring a smooth coordination of services.

To become a Provider Relations Specialist at Carolina Complete Health Network, you typically need a Bachelor's degree in Healthcare Administration, Business Administration, Marketing, or a related field, alongside excellent communication skills and a passion for engaging with an audience. Relevant experience in healthcare, managed care, or insurance can be beneficial. An ownership mindset and the ability to handle multiple tasks in a fast-paced environment are critical for success in this role.

The Provider Relations Specialist at Carolina Complete Health Network plays a vital role in supporting healthcare providers by resolving inquiries and issues through excellent communication and problem-solving skills. They educate providers on CCHN operations, coordinate contract management, and ensure compliance with state guidelines, partnering with internal teams to address provider concerns effectively.

Essential skills for a successful Provider Relations Specialist role at Carolina Complete Health Network include strong critical thinking capabilities, excellent organizational skills, and the ability to prioritize tasks efficiently. Moreover, a proactive approach to problem-solving and demonstrated customer service skills paired with the ability to engage empathetically with stakeholders are crucial in fostering healthy relationships with providers.

Carolina Complete Health Network provides a comprehensive benefits package for its Provider Relations Specialists, which includes medical, dental, and vision insurance with premiums partially covered by CCHN, short and long-term disability, annual wellness reimbursement, a 401k plan with company match, and paid parental leave. These benefits reflect CCHN's commitment to supporting the wellbeing of their employees and families.

When answering this question, emphasize your knowledge of the responsibilities, such as serving as a liaison between providers and healthcare plans, resolving inquiries, and contributing to the quality of care provided. Highlight your ability to foster relationships and improve communication lines, and mention any relevant experience in healthcare that supports your understanding.

Discuss your approach to organization and time management. Explain how you assess the urgency and importance of tasks, listing them, and tackling high-priority items first. Providing an example from past experience where you successfully managed multiple responsibilities will illustrate your capability.

It’s important to narrate a specific instance where you handled a conflict effectively. Start by outlining the situation, the steps you took to resolve the issue, and the outcome. Emphasize your communication skills, problem-solving abilities, and commitment to maintaining strong provider relationships.

Share ideas such as organizing training sessions, creating informative materials (like manuals or videos), or leveraging technology for webinars. Discuss your method for ensuring that the information is clear and easily digestible, and emphasize your willingness to provide ongoing support as needed.

Talk about your approach to staying informed about state regulations and guidelines applicable to healthcare provider relations. Mention any previous experiences where you developed or followed compliance protocols, demonstrating your understanding of their importance in the role.

Highlight how empathy can enhance provider relationships and ultimately improve patient outcomes. Provide examples of how you would use empathy to better understand the needs and challenges of healthcare providers, leading to more effective resolutions and support.

Discuss the importance of active listening to understand the provider’s issues fully. Outline steps you would take to address their concerns, including acknowledging their feelings, investigating the issue, and providing a concrete follow-up to ensure resolution and build trust.

Discuss any specific CRM tools or databases you've worked with, and focus on your familiarity with database management and organization. Emphasize your ability to learn new systems quickly and how you ensure accuracy and accessibility of provider information.

Choose a relevant team project where your contribution significantly impacted the outcome. Emphasize collaboration, communication, and skills you used to foster teamwork, showing how your input helped achieve common goals.

Express your genuine interest in working for CCHN by aligning their mission with your values. Discuss what excites you most about the role, the company culture, or their commitment to quality care, reinforcing your passion for making a positive impact in healthcare.