Provider Relations Specialist

Job Summary

A company is looking for a Provider Relations Specialist - Health Plan Contracting.

Key Responsibilities

• Act as the primary liaison between the Health Plan and network providers, addressing questions and concerns
• Maintain relationships with provider networks and respond to inquiries regarding policies, rates, and eligibility
• Train others on policies, procedures, and online tools as needed

Required Qualifications

• Bachelor's degree in Human Resources, Business, or a related field
• Marketing or Sales training preferred
• Knowledge of Managed Care, utilization management, and provider reimbursement
• Ability to handle pressure while maintaining confidentiality
• Strong understanding of health plan procedures and policies