Director of Provider Relations

Job Summary

A company is looking for a Director of Provider Relations and Medical Networks.

Key Responsibilities

• Lead and mentor teams in medical network, provider relations, and medical bill review
• Develop and implement strategies for medical cost containment and compliance
• Manage provider networks and negotiate with medical providers and vendors

Required Qualifications

• Bachelor's degree or equivalent in healthcare administration, business, or related field
• Minimum of 7 years of experience in insurance, specifically in workers' compensation or medical cost containment
• Strong knowledge of provider networks, fee schedules, and pharmacy management
• Demonstrated experience with managed care programs and vendor management
• Familiarity with state workers' compensation regulations and cost strategies