Provider Network Relations Specialist

CareMore Health Management Services, LLC; Los Angeles (CA); On-site; USD 81,000 - 121,000; Full time

Benefits offered by this job

Bonus eligible

Job summary

CareMore Health Management Services, LLC is seeking a Network Relations Consultant to own performance engagement with MDs, develop strong provider relationships, and resolve complex issues. The role emphasizes on-site visits, communication of policy changes, and education to providers.

Responsibilities include contract coordination, training delivery, and monitoring provider utilization patterns to support quality care delivery and satisfaction.

Qualifications

• Bachelor's degree required.
• Minimum of 3 years customer service experience including 2 years as a Network Management Rep.
• Willingness to travel to worksite and other locations as necessary.

Responsibilities

• Owns individual performance engagement for assigned MDs and maintains provider relationships through on-site visits.
• Communicates administrative and programmatic changes and educates providers.
• Resolves complex provider issues and handles appeals for prompt resolution.
• Coordinates non‑negotiated contracts for new and existing providers as needed and researches contract disputes.
• Supports provider training and education on care management policies and billing/reimbursement practices.

Skills

Customer service

Provider relations

Relationship management

On-site visits

Education

Bachelor's degree

Job description

CareMore Health Management Services, LLC is seeking a Network Relations Consultant to own performance engagement with MDs, develop strong provider relationships, and resolve complex issues. The role emphasizes on-site visits, communication of policy changes, and education to providers.

Responsibilities include contract coordination, training delivery, and monitoring provider utilization patterns to support quality care delivery and satisfaction.