Provider Network & Contracting Specialist

Health-Network-One; Miami (FL); On-site; USD 55,000 - 60,000; Full time

Job summary

Health-Network-One is seeking a Provider Relations Representative to recruit, contract, and maintain relationships with physicians, specialists, ancillary providers, and hospitals to support a high-quality, cost-effective provider network.

Remote role with potential travel; responsibilities include territory analysis, contract negotiations, credentialing support, and data-driven evaluation of provider performance within the network.

Qualifications

• Associate degree or equivalent required with healthcare experience.
• 2–3 years in physician offices, HMOs, or managed care environments.
• Experience in provider contracting and network development preferred.

Responsibilities

• Identify and recruit providers to establish contractual agreements.
• Analyze territories to identify recruitment gaps and opportunities.
• Recruit and contract physicians, specialists, ancillary providers, and hospitals with all credentials.
• Conduct site visits to verify compliance with network and regulatory standards.
• Negotiate contracts and reimbursement rates using utilization and claims data.
• Serve as main contact for provider inquiries about contracts and network participation.
• Collaborate with providers to integrate services into the care delivery network.
• Maintain data integrity in provider files and company systems.
• Support credentialing with collection and maintenance of documentation.

Skills

Provider contracting

Network management

Managed care operations

Credentialing

Data analysis

Education

Associate’s degree or equivalent

Job description

Health-Network-One is seeking a Provider Relations Representative to recruit, contract, and maintain relationships with physicians, specialists, ancillary providers, and hospitals to support a high-quality, cost-effective provider network.

Remote role with potential travel; responsibilities include territory analysis, contract negotiations, credentialing support, and data-driven evaluation of provider performance within the network.