Medical Network Provider Relations Lead

Judi Health, LLC; Denver (CO); Híbrido; USD 110 000 - 158 000; Tempo integral

Resumo da oferta

Judi Health is seeking a Medical Network Provider Relations Manager to build and maintain strong relationships with providers, facilities, and network partners. The role serves as the primary liaison to ensure provider satisfaction, contract compliance, and network performance across a hybrid setup with offices in multiple cities, including Denver.

You will collaborate with internal teams to optimize engagement and drive strategic growth.

Qualificações

• Bachelor's degree in Healthcare Administration, Business Administration, Healthcare Management, or a related field.
• Minimum 5 years of experience in provider relations, healthcare network management, account management, managed care, or healthcare operations.
• Strong knowledge of healthcare provider networks, claims processing and reimbursement methodologies, contracting and credentialing, and compliance requirements.
• Experience managing provider relationships and resolving complex provider issues.
• Excellent communication, negotiation, presentation, and interpersonal skills.
• Proficiency with Microsoft Office Suite and CRM or provider management systems.

Responsabilidades

• Build and maintain strong relationships with healthcare providers, physician groups, hospitals, ancillary providers, and network partners.
• Serve as the primary point of contact for providers regarding operational, contractual, and service-related matters.
• Conduct regular provider outreach, meetings, and educational sessions to promote engagement and satisfaction.
• Develop and execute provider engagement strategies that support network growth and retention.
• Manage and resolve provider inquiries related to claims, reimbursement, network participation, credentialing, and operational processes.
• Collaborate with internal departments to investigate and resolve provider escalations in a timely manner.
• Monitor provider satisfaction trends and proactively address concerns.
• Ensure providers receive accurate and timely information regarding policies, procedures, and network requirements.
• Monitor provider performance and participation to ensure network adequacy and service excellence.
• Analyze provider performance metrics, service trends, and network utilization data.
• Develop reports and presentations for leadership regarding provider network performance.
• Identify opportunities for process improvements and operational efficiencies.
• Collaborate with Claims, Contracting, Credentialing, Provider Data Management, Operations, and Client Services teams.
• Act as a provider advocate within the organization to ensure provider perspectives are considered in decision-making.
• Participate in client meetings and strategic initiatives involving provider network management.
• Support implementations, acquisitions, network expansions, and special projects.

Conhecimentos

Provider relations

Contracting

Credentialing

Regulatory compliance

Negotiation

Communication

Formação académica

Bachelor's degree in Healthcare Administration or related field

Ferramentas

CRM systems

Microsoft Office

Descrição da oferta de emprego

Judi Health is seeking a Medical Network Provider Relations Manager to build and maintain strong relationships with providers, facilities, and network partners. The role serves as the primary liaison to ensure provider satisfaction, contract compliance, and network performance across a hybrid setup with offices in multiple cities, including Denver.

You will collaborate with internal teams to optimize engagement and drive strategic growth.