Director of Provider Relations

Job Summary

A company is looking for a Director of Health Plan Provider Relations.

Key Responsibilities

• Oversees provider relations functions and daily operations, including education and outreach
• Develops strategies for provider network adequacy and collaborates with stakeholders on provider services initiatives
• Ensures compliance with business requirements and manages provider communication and training programs

Required Qualifications

• At least 8 years of provider services experience with Medicaid, Medicare, or Marketplace products
• At least 3 years of management/leadership experience
• Strong understanding of the health care delivery system and managed care compensation methodologies
• Previous experience with community agencies and providers
• Proficiency in Microsoft Office suite and applicable software programs