Provider Relations Advocate - Remote

This is a Fully Remote Job About Our Client:The organization operates globally in the healthcare industry, focusing on improving health outcomes by connecting individuals with care, pharmacy benefits, data, and resources. It addresses challenges related to healthcare access and service quality by leveraging technology and comprehensive care programs to support millions in living healthier lives. The organization maintains a culture centered on inclusion and career development, impacting communities on a large scale. About the Opportunity:The PROVIDER RELATIONS ADVOCATE role is designed to manage comprehensive provider relations and service interactions, including provider claims and call quality, physician portal usability, and external provider education. This position plays a key role in building and maintaining positive relationships between the health plan and providers, while supporting network development and operational improvements. The role contributes to enhancing service quality and network effectiveness within a fast-paced, performance-driven environment. Responsibilities:Assist with end-to-end provider claims and improve call qualityCoach and guide team membersSupport enhancements to the physician portal and related servicesDesign and implement programs to foster positive relationships with providers and practice managersDevelop and deliver training programs for external providersIdentify network composition gaps and assist contracting and development teams Requirements:High school diploma or equivalent experience5+ years in healthcare or managed care3+ years in provider relations or network experience1+ years with Medicare and Medicaid regulationsIntermediate proficiency in claims processing and issue resolutionProficient in MS Word, Excel, PowerPoint, and AccessValid driver’s license and reliable transportation Pay Range and Compensation Package:Salary ranges from $60,200 to $107,400 annually based on full-time employment Benefits & Perks:401(k) contribution Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note:TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.