Emily J Lee
Gladstone,OR
Summary
Senior provider relations professional with extensive experience mentoring and training physician practices. Led educational sessions and resolved provider conflicts to improve relations and operational efficiency. Recognized for high productivity and timely task completion through structured execution.
Overview
31
31
years of professional experience
Work History
Senior Provider Relations Representative
Providence Health Plan
Portland, OR
01.1999 - Current
- Act as primary liaison for 1500 physicians across all Providence hospitals, providing training and support to enhance workflow efficiency.
- Provide strategic guidance on contract negotiations, ensuring alignment with PHP goals and compliance standards.
- Lead resolution of escalated provider disputes by identifying root causes and implementing corrective action, enhancing provider experience.
- Manage the Multnomah County area, providing personalized support and service to maintain long-lasting relationships with large provider groups, including The Oregon Clinic, Providence Medical Group, and Compass Oncology.
- Liaison between providers and internal departments, ensuring effective collaboration, including Providence St. Joseph Health clinic and provider.
- Lead initiatives to streamline provider onboarding processes, enhancing efficiency with CAQH.
- Mentor and train new Provider Relations Representatives on best practices for provider engagement and conflict resolution techniques.
- Facilitate training sessions for Provider Relations and Contracting teams, improving understanding of provider-related policies and procedures.
- Perform site visits for current and potential network providers, showcasing the value-adds and benefits of joining PHP's network. Deliver educational presentations to large provider groups.
- Provide exceptional service to providers during the credentialing and contracting process, ensuring a smooth experience.
- Develop training materials for new Provider Relations Representatives, facilitating onboarding experience and improving job performance.
- Manage recruitment and maintenance of multi-specialty provider network, ensuring compliance with network adequacy standards and identifying gaps for recruitment.
- Organize annual retreats for the statewide Provider Relations team, facilitating team-building and strategic planning.
Account Specialist - Large Group Sales
Providence Health Plan
Portland, OR
01.1997 - 01.1999
- Partnered with Sales team to upsell products and services, directly contributing to increased revenue.
- Supported large group Sales Account Executive team in generating quotes for employer groups with 50 or more employees, contributing to streamlined sales processes.
- Managed client accounts, ensuring accuracy of information and timely updates to enhance client satisfaction.
- Managed multiple accounts simultaneously, demonstrating exceptional organizational skills and attention to detail.
Intake Specialist
Providence Home Services
Portland, OR
01.1996 - 01.1997
- Processed patient intake for Providence Home Services and verified referral documents.
- Coordinated intake processes to enhance service delivery speed and client satisfaction.
- Reviewed insurance coverage and authorization details for home health admissions.
- Verified insurance policies with multiple companies to facilitate timely scheduling of Home Health visits.
- Coordinated communication with physicians, nurses, and case managers.
Education
Bachelor of Science - Healthcare Administration
Oregon State University
Corvallis, ORSkills
- Provider network management
- Provider relationship management
- Provider engagement
- Provider recruitment
- Health plan operations
- Health Plan interpretation
- Contract interpretation
- Dispute mediation
- Effective presentation
- Provider training
- Network management
- Analytical thinking
- Critical thinking
- Team collaboration
- Software proficiency
- Provider retention
Personal Information
Title: Senior Provider Relations Representative
Affiliations
- Volunteer, Meals on Wheels, Portland, OR
- Volunteer, Oregon Humane Society, Portland, OR
Timeline
Senior Provider Relations Representative
Providence Health Plan
01.1999 - Current
Account Specialist - Large Group Sales
Providence Health Plan
01.1997 - 01.1999
Intake Specialist
Providence Home Services
01.1996 - 01.1997
Bachelor of Science - Healthcare Administration
Oregon State University