Provider Relations Account Executive

Independent Living Systems, llc; Miami (FL); On-site; USD 85,000 - 120,000; Full time

Job summary

Independent Living Systems (ILS) is seeking a Provider Relations Account Executive in Miami, FL to build and sustain a high-performing provider network for Florida Community Care and Florida Complete Care.

You will lead contract negotiations, monitor performance, and collaborate across care management, compliance, and finance to improve access and quality for members.

Qualifications

• Bachelor’s degree in Healthcare Administration, Business, or related field.
• 3 years of provider relations, account management, or similar healthcare experience.
• Strong knowledge of provider networks, contract negotiation, and regulatory compliance.
• Proficiency in Microsoft Office Suite and experience with healthcare management software.
• Relevant experience may substitute for educational requirement on a year-for-year basis.

Responsibilities

• Develop and maintain strong collaborative relationships with providers to ensure network adequacy and quality.
• Facilitate development, negotiation, and execution of provider contracts, ensuring regulatory compliance.
• Monitor provider performance metrics and implement corrective action plans as needed.
• Serve as the primary contact for assigned providers and coordinate with departments to resolve inquiries and disputes.
• Maintain accurate records of provider interactions and follow up on outstanding issues.
• Collaborate with care management, compliance, and finance to support provider network initiatives and improve service delivery.
• Ensure high levels of provider satisfaction through exceptional service.

Skills

Provider networks

Contract negotiation

Regulatory compliance

Microsoft Office

Healthcare software

Education

Bachelor’s degree in Healthcare Administration/Business

Master’s degree in Healthcare Administration/Business

Tools

N/A

Job description

Full Time Professional Miami, FL, US

Provider Relations Account Executive

We are seeking a Provider Relations Account Executive to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.

About the Role:

The Provider Relations Account Executive plays an essential role in fostering and maintaining strong partnerships between our healthcare organization and a diverse network of providers. The Provider Relations Account Executive position is responsible for ensuring seamless communication, addressing provider concerns, and facilitating contract negotiations to optimize service delivery and network growth. The Provider Relations Account Executive will work collaboratively with internal teams to align provider capabilities with organizational goals, enhancing member access and satisfaction. By proactively managing provider relationships, the Provider Relations Account Executive contributes to the overall efficiency and quality of healthcare services offered. Ultimately, the Provider Relations Account Executive drives the expansion and retention of a high-performing provider network that supports the organization's mission and strategic objectives.

Minimum Qualifications:

• Bachelor's degree in Healthcare Administration, Business, or a related field.
• 3 years of experience in provider relations, account management, or a similar role within the healthcare industry.
• Strong knowledge of healthcare provider networks, contract negotiation, and regulatory compliance.
• Proficiency in Microsoft Office Suite and experience with healthcare management software.
• Relevant experience may substitute for educational requirement on a year-for-year basis.

Preferred Qualifications:

• Master's degree in Healthcare Administration, Business, or a related discipline.
• Experience working with managed care organizations or health insurance providers.
• Familiarity with healthcare data analytics and performance measurement tools.
• Demonstrated success in managing complex provider networks and multi-stakeholder projects.
• Certification in healthcare management or provider relations (e.g., Certified Provider Relations Specialist).

Responsibilities:

• Develop and maintain strong collaborative relationships with providers through high-touch communication to ensure network adequacy and quality and other provider performance goals are met.
• Facilitate the development, negotiation, and execution of provider contracts, ensuring terms meet regulatory standards and organizational policies.
• Monitor provider performance metrics and work with providers to implement corrective action plans when necessary.
• Serve as the primary point of contact for all assigned providers, and as a link to various departments to address inquiries, resolve disputes, and maintain positive partnerships..
• Maintain accurate records of provider interactions and follow up on outstanding issues to ensure timely resolution.
• Collaborate with cross-functional teams including care management, compliance, and finance to support provider network initiatives and improve service delivery. opportunities for growth and expansion within existing provider accounts.
• Ensure high levels of provider satisfaction by providing exceptional service and support.