Provider Network Relations Specialist

American Health Partners; Hattiesburg (MS); Hybrid; USD 60,000 - 90,000; Full time

Benefits offered by this job

Medical/Dental/Vision

PTO & Holidays

TeleDoc

Disability Plans

EAP

401K

Referral Bonus

Job summary

American Health Plans, a division of American Health Partners Inc., seeks a qualified professional to contract and educate providers across service areas and maintain CMS adequacy. The role requires collaboration with networks, strong negotiation skills and independent work habits.

Travel to network provider locations is required; teleworking is an option if criteria are met, and excellent MS Office skills are expected. Bachelor's degree is required.

Qualifications

• Must be fluent with provider payment methodologies and understand CMS rules.
• Experience building working relationships with medical providers and facilities.
• Ability to work independently and meet goals with minimal supervision.

Responsibilities

• Contract providers and vendors in current service areas to ensure CMS adequacy.
• Ensure providers meet credentialing requirements for service lines.
• Educate providers on Health Plan functions and roles; provide CMS guidance updates.

Skills

Provider relations

Negotiation

Communication

MS Office

Teamwork

Education

Bachelor's degree

Tools

MS Office Suite

Job description

American Health Plans, a division of American Health Partners Inc., seeks a qualified professional to contract and educate providers across service areas and maintain CMS adequacy. The role requires collaboration with networks, strong negotiation skills and independent work habits.

Travel to network provider locations is required; teleworking is an option if criteria are met, and excellent MS Office skills are expected. Bachelor's degree is required.