Provider Relations Rep

We're excited you're considering joining a great place to work!

Texas Mutual is deeply committed to creating and maintaining an environment of mutual respect and is proud to be an equal opportunity employer. All qualified applicants are encouraged to apply and will receive consideration for employment without regard to age, race, color, national origin, religion, sex, gender identity, sexual orientation, genetic information, veteran status, or any other basis protected by local, state, or federal law.

About this Position

At Texas Mutual, we're on a mission to build a stronger, safer Texas. As the largest workers' compensation provider in Texas, we help injured workers return to a productive life, give businesses the tools to thrive, invest in our communities, and empower our employees to do their best work.

Texas Mutual takes care of injured workers by providing top-notch medical care when an accident occurs. As a Provider Relations Rep, you will be part of the team that executes workers' compensation medical network initiatives and ensures that the provider network is performing consistent with contracted service level agreements. In this role, you will collaborate with agents, policyholders, underwriting and claim personnel to address issues and concerns with the medical network. You will report to the Provider Network Supervisor.

Responsibilities & Qualifications

As a Provider Relations Rep, you will:

• Conduct the contract and credentialing process for Texas Mutual Insurance Company's (TXM) direct provider contracts through screening incoming provider applications and agreements for completeness and following up with letters and/or telephone calls to obtain incomplete or missing information. Recruit and credential providers in accordance with regulatory requirements and/or customer service requests.

• Monitor provider coverage and cost effectiveness through review of data, mapping and provider bill analysis and develop action plans as needed to address any gaps.

• Assist internal customers with locating providers and facilities.

• Collaborate with the network team and develop solutions to issues from agents, policyholders, regulators, underwriting, claim personnel, and others, as appropriate and provide recommendations to management.

• Analyze network provider outcomes and educate and/or remove providers who do not achieve TXM outcome expectations.

• Maintain effective working relationships with network vendor's to facilitate TXM achieving its network outcomes, contracted service level agreements and regulatory compliance standards.

• Develop provider education and training materials for network provider workshops, seminars and newsletters.

• Train and/or inform internal departments about the implementation of network processes.

• Develop network marketing and/or network presentations suitable for internal and external customer and/or upper management.

• Travel throughout the state to meet and build relationships with key agents and network medical providers.

Required Qualifications:

• A bachelor's degree or equivalent education, training, or experience.

• Two to four years of related work experience or any equivalent combination of education, training, or experience.

• Have and maintain a valid Texas Driver's license.

Flex-Hybrid Work Environment:

Texas Mutual's flex-hybrid schedule allows you to bring your best self to work by working remotely and collaborating in the office based on business needs. All Texas Mutual employees are required to have Texas residency and travel to their designated office as needed.

Our Benefits:

• Annual performance bonus and merit-based pay increase

• Lifestyle Savings Account ($1,000 per year)

• Automatic 4% employer contribution to retirement plan

• 401k plan with 100% employer match up to 6%

• Student loan repayment matching in 401k plan

• Three weeks' time off for vacation

• Nine paid holidays and two personal days each year

• Day one health, Rx, vision and dental insurance

• Life and disability insurance

• Flexible spending account

• Pet insurance and pet Rx discounts

• Free on-site gym, fitness classes, and health and wellness resources

• Free identity theft protection

• Free student loan repayment and refinancing consultation

• Professional development and tuition reimbursement

• Employee referral bonus

• Free onsite snacks