Provider Relations Manager - Remote

About the role

The Provider Relations Manager is responsible for managing the provider experience within a medium to low complexity book of business. They collaborate with matrix partners to drive service improvements, resolve issues, and develop strategic plans with providers. The role involves external engagement, education on policies, serving as a provider advocate, and participating in community and joint operating committee activities.

Responsibilities

• Creating provider action plans
• Identifying market opportunities and risks
• Analyzing provider data
• Promoting performance score improvements
• Collaborating with matrix partners to drive service improvements and resolve issues
• Developing strategic plans with providers
• External engagement and education on policies
• Serving as a provider advocate
• Participating in community and joint operating committee activities
• Position may require up to 10% travel

Qualifications

• Bachelor’s degree or equivalent experience
• 5+ years in provider relations, account management, or claims administration (preferred)

Skills

• Strong communication skills
• Analytical skills
• Negotiation skills
• Understanding of medical insurance
• Proficiency with Outlook, Teams, Excel, PowerPoint
• Experience with Proclaim or Facets (advantageous)

Benefits

Offers competitive salary and benefits supporting overall health and well-being.