o Ensure provider relationships with the plan are positive for both partieso Work with providers to understand issues/concerns. Identify root cause of problems & trends and participate in developing solutionso Create & maintain information required to support the network development processo Conduct site visits, provider education, orientations & provider servicing visits to ensure providers are well-acquainted with the plansbenefits, policies, and procedures.o Participate in standing meetings, as necessary, regarding providerreimbursement issues & network development activitieso Track & respond to telephonic, and written inquiries from providersand document all contacts

o Network reporting to senior management to ensure regulatoryrequirements are being met.o Provider Service – Including but not limited to claims/billing/payment inquiries, tracking and respondingo Document all provider contact, including telephonically, emails,visits, and written correspondenceo Develops training materials and conducts on-site provider education,orientations, and provider servicing visits to ensure providers are wellacquainted with CPHL benefits, policies and procedureso Provides follow up and intervention relating to provider complaintsand inquiries, thereby ensuring the complaint/inquiry process ishandled within established time frames

o Updated databases using Microsoft Access o Updated patient info and rates using Microsoft Excelo Updated patient letters using Microsoft Wordo Sat in on negotiation meetings between providers and hospitals