Provider Network Relations Specialist

American Health Partners; Dallas (TX); Hybrid; USD 70,000 - 100,000; Full time

Benefits offered by this job

Medical/Dental/Vision insurance

PTO and holidays

TeleDoc 24/7/365

Disability plans

EAP

401K

Referral bonus

Job summary

American Health Plans, a division of American Health Partners, seeks a network/credentialing liaison in Dallas to manage provider relationships and education. The role supports CMS adequacy and network coverage.

The candidate should bring healthcare experience, strong negotiation and communication skills, and the ability to work independently within a team. Teleworking may be available and travel is required.

Qualifications

• Knowledge of medical services and ability to build relationships quickly.
• Able to work independently to complete goals.
• Strong negotiation, organization, presentation, and time-management skills.
• Effective communication with medical staff to explain plan benefits and goals.
• Ability to work well in a team environment.
• Excellent computer skills, including MS Office.
• Self-motivated, dependable, and goal-oriented.

Responsibilities

• Contract providers and essential vendors to maintain CMS adequacy and services for Plan members.
• Ensure providers meet credentialing requirements for their service lines.
• Educate providers on Health Plan functions and roles in caring for members.
• Provide ongoing CMS-prescribed educational updates.
• Deliver provider education presentations to ensure understanding and commitment.
• Monitor and support provider relationships to guarantee network coverage.
• Assist in implementation as needed and contribute to process improvements.
• Foster a positive work environment and complete corporate assignments.

Skills

Medical knowledge

Independent work

Negotiation

Communication

Team player

MS Office

Self-motivated

Education

Bachelor’s degree

Tools

Microsoft Office Suite

Job description

American Health Plans, a division of American Health Partners, seeks a network/credentialing liaison in Dallas to manage provider relationships and education. The role supports CMS adequacy and network coverage.

The candidate should bring healthcare experience, strong negotiation and communication skills, and the ability to work independently within a team. Teleworking may be available and travel is required.