Provider Relations Account Executive

Careerwebsite; Tallahassee, Northern (FL, KY); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Independent Living Systems (ILS) is seeking a Provider Relations Account Executive in Florida to cultivate and manage a robust provider network. You will coordinate communications, address provider concerns, and support contract negotiations to optimize service delivery and network growth.

Responsibilities include ensuring regulatory compliance, maintaining strong provider relationships, and collaborating with care management, compliance, and finance teams to improve member access and

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.

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 départements 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.

Skills

Provider relations

Account management

Contract negotiation

Regulatory compliance

Microsoft Office

Education

Bachelor’s degree in Healthcare Administration / Business or related field

Master’s degree in Healthcare Administration or related discipline

Tools

Healthcare management software

Microsoft Office Suite

Job description

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.

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.

About the Role:

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 départements 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.