Director of Provider Relations

Job Summary

Leading a team in health plan provider relations, the full-time Director of Provider Relations will manage provider education, network development, and compliance while serving as the primary contact for contracted providers in a remote setting.

Key responsibilities

• Oversees daily operations of the provider relations team, including education and outreach activities
• Develops strategies for network adequacy and provider engagement to ensure high-quality care for members
• Collaborates with cross-functional teams to implement best practices and standards in provider services

Required qualifications

• At least 8 years of provider services experience with Medicaid, Medicare, or Marketplace products
• Minimum of 3 years in management or leadership roles
• Strong understanding of healthcare delivery systems and various provider compensation methodologies
• Experience with community agencies and providers
• Proficiency in Microsoft Office suite and applicable software programs