Provider Relations Officer

Maxicare Healthcare Corporation; Benguet; On-site; PHP 450,000 - 800,000; Full time

Job summary

Maxicare Healthcare Corporation seeks a Provider Relations Officer – Physicians to grow and manage a robust network of accredited physicians. You will negotiate contracts, review applications for accreditation, and resolve provider concerns while collaborating with Legal, Finance, and Operations to ensure compliant contract implementation.

The role requires onsite work in Baguio City with travel within the assigned area, offering opportunities to enhance network engagement and service delivery.

Qualifications

• Bachelor's degree in a related field.
• Strong negotiation and stakeholder management skills.
• Excellent written and verbal communication and presentation abilities.
• Analytical mindset with attention to detail.
• Proficient in MS Office applications.
• Willingness to travel within the assigned area.

Responsibilities

• Build and expand Maxicare's physician network by sourcing, evaluating, and accrediting providers.
• Review applications to ensure accreditation and regulatory compliance.
• Negotiate physician contracts and renewals while minimizing business risks.
• Coordinate contract preparation with Legal and internal stakeholders.
• Serve as the primary contact for contract inquiries, renewals, and amendments.
• Develop and maintain relationships with accredited physicians through visits and engagements.
• Address provider concerns related to claims, payments, contracts, and policies.
• Conduct physician performance evaluations and communicate results for improvement.
• Collaborate with Legal, Finance, Operations, and Provider Network Management for contract implementation.
• Monitor balance billing and excessive fee cases and resolve them.
• Conduct market research to identify expansion opportunities.
• Prepare reports and provider-related documentation for management.

Skills

Negotiation

Stakeholder management

Relationship-building

Communication

Presentation skills

Analytical thinking

MS Excel

Education

Bachelor's degree in Business Administration/Healthcare Administration/Marketing/Nursing/Medical Technology/Public Health

Tools

MS Office

Job description

Accountability Statement

The Provider Relations Officer – Physicians is accountable for developing and maintaining a strong network of accredited physicians by managing provider relationships, negotiating and administering physician contracts, and ensuring effective collaboration between Maxicare and its partner physicians. The role is responsible for strengthening physician engagement, resolving provider concerns, ensuring regulatory compliance, and supporting the organization's provider network strategy to enhance service delivery, operational efficiency, and customer satisfaction.

Key Responsibilities

• Build and expand Maxicare's physician network by sourcing, evaluating, and accrediting qualified healthcare providers.

• Review physician applications and supporting documents to ensure compliance with accreditation and regulatory requirements.

• Negotiate physician contracts and renewal terms while minimizing business risks and ensuring alignment with company policies.

• Prepare, review, and coordinate physician contracts in partnership with Legal and other internal stakeholders.

• Serve as the primary point of contact for physician contract inquiries, renewals, amendments, and related concerns.

• Develop and maintain strong relationships with accredited physicians through regular visits, meetings, and engagement activities.

• Address and resolve physician concerns related to claims, payments, contract administration, and company policies.

• Conduct physician performance evaluations and communicate results to support continuous improvement and partnership development.

• Coordinate with internal departments, including Legal, Finance, Operations, and Provider Network Management, to ensure efficient contract implementation and provider support.

• Monitor and resolve balance billing and delayed discharge cases related to physician excess fees.

• Conduct market and industry research to identify opportunities for expanding and improving the physician network.

• Prepare reports, presentations, and provider-related documentation to support management decision-making.

• Ensure compliance with company policies, regulatory requirements, governance standards, and risk management practices.

• Perform other duties and special projects as assigned by management.

Qualifications

• Bachelor's degree in Business Administration, Healthcare Administration, Marketing, Nursing, Medical Technology, Public Health, or any related field.

• Strong negotiation, stakeholder management, and relationship-building skills.

• Excellent verbal and written communication and presentation skills.

• Strong analytical and problem-solving skills with attention to detail.

• Proficient in Microsoft Office applications (Excel, Word, PowerPoint).

• Ability to work independently and collaborate effectively with cross-functional teams.

• Willing to travel within the assigned area as required.

• Must be willing to work on-site in Baguio City.

Experience

• At least 3 years of relevant experience in provider relations, account management, healthcare operations, business development, or contract management.

• Experience in the healthcare, HMO, hospital, insurance, or pharmaceutical industry is an advantage.

• Proven experience in contract negotiation, client relationship management, and stakeholder engagement.

• Experience coordinating with physicians, healthcare providers, hospitals, or medical institutions is highly preferred.

• Experience handling provider concerns, accreditation, or network management is an advantage.