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SalaryJoin us for an exciting career with the leading provider of supplemental benefits!
Our Promise
Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.
The Provider Relations Supervisor is tasked as part of the Provider Relations Department, to be the liaison between Avesis and the participating provider network. The Provider Relations Supervisor will be responsible for coordinating efforts and assisting with the overall success of the Provider Relations Department to build and nurture positive relationships with the Avesis eye care/dental/hearing provider community to include but not limited to best in class provider education and training, issues research and projects.Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.
Essential Job Functions:
- Assist the Provider Relations Manager with oversight in managing and leading the overall success of the Provider Relations Department, driving a positive Avesis provider experience and provider satisfaction.
- Conduct scheduled team meetings with assigned team as well as schedule individual meetings with staff.
- Operate and function as the leader with a take charge attitude.
- Be able to hold difficult conversations as well as empower employees through positive conversations.
- Serve as a Subject Matter Expert (SME) and escalation point to coach Provider Relations/Services staff in providing the best service experience and timely issue resolution possible.
- Accountable leader for the Provider Relations/Services staff in their effectiveness, career development, and team morale
- Partner with cross-functional departments to develop and implement operational improvements to daily workflows.
- Accountable leader to the Provider Relations team success to include department operational, quality, and individual KPIs.
- Conducts provider outreach by providing training and guidance to enable Avesis network providers to become more self-sufficient in confirming eligibility, claims submission and payment by use of available tools.
- Responds to general provider contract inquiries, provider education and non-routine claim issues and may research, analyze, and recommend resolution for provider disputes.
- Ability to review and negotiate fee exceptions and submit documentation through the proper channels.
- Understanding of health insurance claims, as well as an ability to analyze data to resolve provider service issues.
- Working knowledge of credentialing process
- Perform onsite facility reviews, when applicable and conduct quarterly face-to-face visits within the assigned territories and/or markets. Work closely and coordinates with Avesis Claims, Customer Service, Utilization Management, Clinical Management, Credentialing, Recruitment, Account Management, and other staff to develop operational solutions for various provider network projects.
- Investigate and respond to complex provider related issues and initiate change of provider related database information.
- Knowledge of and ability to use various computer programs such as Microsoft Office including spreadsheet, word processing and presentation software and programs/systems utilized in data analysis.
- Ability to prioritize and organize a diverse workload required.
- Excellent verbal and written communication and effective listening skills required.
- Attend work-related events/conferences while representing the organization and brand in a professional manner.
- Other duties as assigned.
Qualification Requirements:
- High School Diploma or equivalent required: Bachelor’s Degree preferred
- 3+ years government and/or commercial vision and/or medical background required.
- 1+ years in a Leadership capacity (management, projects, processes, etc.)
- Provider Relations experience preferred.
- Knowledge of health plan operations preferred.
- Certified Ophthalmic Assistant, Certified Ophthalmic Technician, and Certified Ophthalmic Medical Technician desired.
- Intermediate PowerPoint skills required; ability to highlight details, provide visual structure using themes, importing Excel data, adding links, playing video files, using animation, and preparing for a live slideshow.
- Microsoft applications and other windows-based applications to include a moderate level in Microsoft Excel, Microsoft Word, Microsoft OneNote, and databases.
- Self-Starter with ability to work independently and as part of a team.
- Must be highly organized, detail oriented and a self-starter with strong managerial skills and a track record of success in a fast-paced organization.
- Excellent time management skills
- Excellent verbal and written communication skills
Travel Requirements:
A valid driver's license with proof of auto insurance and the ability to use your own vehicle is required. The ability to travel up to 50% is required to meet prospective clients, existing customers, attend trade shows and other meetings as needed. Travel requirements may vary at different times of the year and can range from short/overnight trips to extended stays, visiting different regions to oversee project/client implementation or to provide guidance to our customers. Modes of transportation may also include public transportation, such as rail, bus, car and/or plane. Travel/mileage reimbursement will be provided in alignment with the IRS annual mileage program and/or receipts submitted through the company expense report policy.
FLSA Status: Salary/Exempt
Hourly Range: $55,790 - $87,230
How to stay safe:
Avesis is aware of fraudulent activity by individuals falsely representing themselves as Avesis recruiters. In some instances, these individuals may even contact applicants with a job offer letter, ask applicants to make purchases (i.e., a laptop or gift cards) from a designated vendor, have applicants fill out W-2 forms, or ask that applicants ship or send packages of goods to the company.
Avesis would never make such requests to applicants at any time throughout our job application process. We also would never ask applicants for personal information, such as passport numbers, bank account numbers, or social security numbers, during process. Our recruitment process takes place by phone and via trusted business communication platform (i.e., Zoom, Webex, Microsoft Teams, etc.). Any emails from Avesis recruiters will come from a verified email address ending in @Avesis.com.
We urge all applicants to exercise caution. If something feels off about your interactions, we encourage you to suspend or cease communications. If you are unsure of the legitimacy of a communication you have received, please reach out to
ITsupport@Avesis.com
. To learn more about protecting yourself from fraudulent activity, please refer to this article link (
https://consumer.ftc.gov/articles/how-avoid-scam
). If you believe you were a victim of fraudulent activity, please contact your local authorities or file a complaint (Link: https://reportfraud.ftc.gov/#/
) with the Federal Trade Commission. Avesis is not responsible for any claims, losses, damages, or expenses resulting from unaffiliated individuals of the company or their fraudulent activity. We Offer
- Meaningful and challenging work opportunities to accelerate innovation in a secure and compliant way.
- Competitive compensation package.
- Excellent medical, dental, supplemental health, life and vision coverage for you and your dependents with no wait period.
- Life and disability insurance.
- A great 401(k) with company match.
- Tuition assistance, paid parental leave and backup family care.
- Dynamic, modern work environments that promote collaboration and creativity to develop and empower talent.
- Flexible time off, dress code, and work location policies to balance your work and life in the ways that suit you best.
- Employee Resource Groups that advocate for inclusion and diversity in all that we do.
- Social responsibility in all aspects of our work. We volunteer within our local communities, create educational alliances with colleges, drive a variety of initiatives in sustainability.
Equal Employment Opportunity
At Avēsis, We See You. We celebrate differences and are building a culture of inclusivity and diversity. We are proud to be an Equal Employment Opportunity employer that considers all qualified applicants and does not discriminate against any person based on ancestry, age, citizenship, color, creed, disability, familial status, gender, gender expression, gender identity, marital status, military or veteran status, national origin, race, religion, sexual orientation, or any other characteristic. At Avēsis, we believe that, to operate at the peak of excellence, our workforce needs to represent a rich mixture of diverse people, all focused on providing a world-class experience for our clients. We focus on recruiting, training and retaining those individuals that share similar goals. Come Dare to be Different at Avēsis, where We See You!
