This role has recently opened up and it’s a great time to join Fallon Health as we anticipate a strong year. Our Provider Relations operation is central to success as Fallon continues to grow service offerings and membership in the Medicaid and Medicare space. Although Provider Relations has a strong foundation this is still a great opportunity for a new person to come in and make a big impact as we evolve in new business directions. This is a visible role as you and your team will represent the face of Fallon with all our providers and providers groups.
About Fallon Health
Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.
The Director, Provider Relations manages the activities of the Provider Relations function and its staff, which serves as Fallon Health Plan's liaison to the provider network as well as Fallons relationship with various contracted provider vendors. The Director also oversees the production of the provider newsletter as well as the education of providers for each of the various Fallon products and changes that are implemented. The Director works closely with other internal Fallon departments to resolve problems and issues that arise within the provider networks. Must have a solid understanding of provider fee schedules, claim policies and procedures as well as provider payment policies. The Director also leads the Provider Business Council.