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Provider Relations Representative resume examples

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Skills

  • Team development
  • Mentoring and coaching
  • Dispute resolution
  • Territory sales
  • Interpersonal skills
  • Psychiatric and Mental Health Care
  • Cardiology
  • Chemistry
  • Private practice experience
  • Recruiting and training

Work Experiences

  • Promoted the company as a superior provider dedicated to the needs and satisfaction of customers.
  • Gave product demonstrations at customers' homes, answering questions and redirecting objections in order to close sales.
  • Kept contract risks under controlled by working closely with and training providers on policies and procedures.
  • Pushed for the launch of a contact management system in order to achieve 100% client organization.
  • Handled over 12 calls per day while maintaining a high level of customer satisfaction.
  • Built professional client relationships by asking the right questions, identifying needs, and providing useful product information.
  • Evaluate potential contracting arrangements and rate negotiations to ensure that cost-effective and high-quality service is delivered.
  • Looked at complex and unusual claims to see if they were covered.
  • Assisted in the expansion of the initiative network and the efficient management of membership increases.
  • Talked to long-term, new, and prospective customers to figure out their needs and come up with the best solutions.

Summaries

  • Team player who is hardworking, conscientious, and resourceful.
  • With knowledge of QuickBooks use, adept at working closely with midwives and doctors.
  • With 11 years of direct patient care experience, I am a dedicated Critical Care Registered Nurse.
  • Communicative and team-oriented, with Jira expertise.
  • Clinical Nurse with extensive knowledge of strategic planning and the ability to create individualized care plans.
  • Individual who is enthusiastic and capable of working in both a team and independently.
  • Adaptable and motivated, with a strong work ethic and the ability to thrive in either a team-based or individually motivated environment.
  • Performance-driven Healthcare professional with a proven track record of connecting with framework customers and generating exceptional Power BI sales.
  • Nurse who specializes in supply management, documentation, and referrals for children.
  • Registered Nurse with 11 years of experience in critical care.

Accomplishments

  • Liaised
  • Consulted
  • Facilitated
  • Comforted
  • Patient Care: Ensured quality control through admissions, assessment, treatment, and referral for a broad range of patients. Treated patients suffering from trauma, acute chest pain, respiratory failure, and drug overdoses.
  • Documented
  • Living Assistance: Served meals, assisted with feeding ambulating and turning and positioning in bed.
  • Nursed
  • Observed
  • Recognized

Affiliations

  • Attended Health Plan Alliance (HPA) events to foster collaborative relationships with diverse provider networks
  • Active membership in the Association for Community Affiliated Plans (ACAP) to advocate for policies benefiting healthcare providers
  • Obtained the Certified Medical Manager (CMM) designation through the Professional Association of Health Care Office Management (PAHCOM)
  • Attendee of National Association for Healthcare Quality (NAHQ) conferences and workshops for continuous education on network management practices
  • Certified Professional in Healthcare Quality (CPHQ) through NAHQ for improved compliance tracking
  • Member of the American College of Medical Practice Executives (ACMPE) focusing on strategic KPI analysis
  • Workshop leader at the National Health Care Anti-Fraud Association (NHCAA) annual summit on provider compliance best practices
  • Completion of Advanced Healthcare Leadership Program by system focused on contract negotiations
  • Member of the Medical Group Management Association (MGMA) with a focus on healthcare provider relations
  • Certified Provider Relations Specialist through the American Academy of Medical Administrators (AAMA)

Certifications

  • Board Certification in Healthcare Management (BCHM) by ACHCA
  • LMSW
  • Certified Business Analysis Professional (CBAP)
  • ANA Certified in School NP
  • Pediatric Advanced Life Support (PALS)
  • CompTIA A+ Technician
  • Salesforce
  • Certified Health Data Analyst (CHDA)
  • Pediatric Education for Prehospital Professionals (PEPP)
  • Pediatric Nursing Certification Board (PNCB)

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