Healthcare Adminstration Provider Relations Representative

FLORIDA DOCTORS GROUP CORP; Coral Gables (FL); On-site; USD 50,000 - 65,000; Full time

Benefits offered by this job

Competitive salary

Dental insurance

Free uniforms

Opportunity for advancement

Paid time off

Training & development

Vision insurance

Job summary

Florida Doctors Group in Coral Gables, FL is seeking a motivated Provider Relations Representative to support active provider relationships, ensure access to resources, and deliver ongoing support throughout the partnership.

The role focuses on onboarding, education, and regular provider engagement, coordinating with Credentialing, Network Data, Quality, and Finance to resolve questions and maintain accurate provider information.

Qualifications

• Prior experience in provider relations or healthcare operations.
• Experience with physicians, medical groups, or office staff.
• Strong communication and interpersonal skills.
• Professional, service-oriented demeanor.
• Ability to manage multiple provider accounts and meet deadlines.
• Proficiency in Microsoft Office and healthcare systems.

Responsibilities

• Serve as primary contact for assigned providers post-activation.
• Build and maintain relationships with providers and office staff.
• Conduct onboarding/orientation with resources and workflows.
• Hold regular meetings to educate providers and review items.
• Provide ongoing training on health plan processes and portals.
• Assist with roster, eligibility, reporting, and health plan requirements.
• Monitor provider accounts and follow up on outstanding items.
• Coordinate provider demographics and updates with internal teams.
• Track provider inquiries and maintain documentation of interactions.
• Conduct in-person provider visits for relationship management.

Skills

Excellent communication

Interpersonal skills

Organizational skills

Detail-oriented

Customer service orientation

Tools

Microsoft Excel

Microsoft Word

PowerPoint

Job description

Benefits:

• Competitive salary
• Dental insurance
• Free uniforms
• Opportunity for advancement
• Paid time off
• Training & development
• Vision insurance

Florida Doctors Group is seeking a motivated and professional Provider Relations Representative to join our growing team. This is a highly hands-on, provider-facing role focused on supporting and maintaining relationships with providers and medical groups once they become active with Florida Doctors Group.

The Provider Relations Representative serves as a primary point of contact between Florida Doctors Group and assigned providers, helping ensure providers understand our processes, have access to the information and resources they need, and receive ongoing support throughout their relationship with the organization.

The ideal candidate is energetic, personable, detail-oriented, highly organized, and comfortable developing strong professional relationships with provider offices in a fast-paced managed care environment.

RESPONSIBILITIES

Serve as a primary point of contact for assigned providers and medical groups following activation with Florida Doctors Group.

Build and maintain strong, ongoing relationships with providers, office managers, and key practice staff.

Conduct provider onboarding and orientation, including an overview of Florida Doctors Group, available resources, workflows, reporting, communication processes, and health plan requirements.

Conduct regular provider meetings and check-ins virtually, by phone, and in person to provide education, address questions, review outstanding items, and maintain provider engagement.

Provide ongoing education and training to providers and their staff as needed, including training related to health plan processes, reporting, portals, eligibility, rosters, and other operational requirements.

Assist providers with questions or concerns regarding membership rosters, member eligibility, reporting, health plan requirements, and other day-to-day operational matters.

Review and discuss applicable operational, quality, utilization, membership, and performance reports with providers and help ensure they understand any required actions or follow-up.

Monitor assigned provider accounts and proactively identify outstanding items, changes, concerns, or areas requiring follow-up.

Coordinate and maintain provider demographic information, including practice locations, contact information, office hours, provider additions or changes, and other applicable updates.

Work with internal departments to ensure provider demographic changes and other maintenance requests are properly communicated and processed.

Communicate health plan requests, notices, documentation requirements, or other action items to assigned providers and follow up to ensure requested information is received within required timeframes.

Serve as a liaison between providers and Florida Doctors Group's internal departments to assist with questions, concerns, and issue resolution.

Coordinate with departments such as Credentialing, Network Data, Quality/HEDIS, Finance, Utilization Management, Membership, and other operational teams when provider assistance is required.

Assist providers in navigating applicable systems, portals, reports, and resources and coordinate additional training when necessary.

Track provider concerns, requests, pending items, and resolutions and maintain clear and accurate documentation of all provider interactions.

Maintain detailed records of provider calls, emails, meetings, office visits, training sessions, requests, and follow-up activities.

Conduct in-person provider office visits as needed for relationship management, education, training, operational support, and follow-up.

Identify provider concerns or recurring operational issues and appropriately elevate matters to management or the applicable department when necessary.

Ensure assigned providers receive timely communication regarding relevant operational changes, health plan updates, deadlines, requirements, and other important information.

Maintain consistent follow-up with providers to ensure outstanding matters are addressed and closed appropriately.

REQUIREMENTS

Prior experience in provider relations, healthcare operations, managed care, medical office administration, or a related healthcare role preferred.

Experience working directly with physicians, medical groups, office managers, or healthcare professionals.

Strong communication and interpersonal skills with the ability to establish and maintain professional provider relationships.

Professional, confident, personable, and service-oriented demeanor.

Strong organizational and follow-up skills with the ability to manage multiple provider accounts and outstanding items simultaneously.

High attention to detail and commitment to accurate documentation.

Ability to communicate healthcare and operational information clearly and professionally.

Ability to work independently while collaborating effectively with multiple internal departments.

Ability to prioritize responsibilities and meet deadlines in a fast-paced environment.

Comfortable conducting provider meetings, training sessions, and presentations both virtually and in person.

Proficiency in Microsoft Excel, Word, PowerPoint, and other standard business applications.

Comfortable learning and navigating healthcare systems, portals, reporting platforms, and internal databases.

Ability and willingness to travel locally to provider offices as required.

PREFERRED QUALIFICATIONS

Experience working with an MSO, IPA, health plan, physician network, or provider relations department.

Familiarity with Medicare Advantage, Medicaid, and managed care operations.

Experience with provider rosters, eligibility, demographic maintenance, provider portals, and health plan reporting.

Experience conducting provider education, onboarding, training, or in-service meetings.

General understanding of HEDIS, quality measures, utilization management, membership, and other managed care reporting is preferred.

ROLE FOCUS

This position is focused on ongoing provider relationship management and operational support after a provider has become active with Florida Doctors Group. The Provider Relations Representative is responsible for maintaining consistent communication with assigned providers, supporting their day-to-day needs, coordinating with internal departments, facilitating education and training, and ensuring provider accounts remain accurate and up to date.

This position does not negotiate provider contracts, capitation rates, risk arrangements, or other contractual terms.

The role provides significant exposure to managed care operations, provider engagement, health plan requirements, quality initiatives, and healthcare network management, with opportunities for continued professional development and growth within Florida Doctors Group.