Provider Network Manager - TX

Verda Healthcare

Houston (TX)

On-site

USD 75,000 - 110,000

Full time

14 days+

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Benefits offered by this job

401(k)

Paid time off (vacation, holiday, sick leave)

Health insurance

Dental Insurance

Vision insurance

Life insurance

Job summary

A healthcare organization in Houston, Texas, is seeking a Provider Relations Manager to build and maintain relationships with Independent Physician Associations and hospitals. This role involves onboarding providers, resolving inquiries, and ensuring contract compliance. Candidates should have a Bachelor’s degree and experience in provider relations or healthcare operations. Benefits include 401(k), paid time off, and health insurance. Join a team focused on improving healthcare access for underserved communities.

Qualifications

3–5 years of experience in provider relations, network management, or healthcare operations with a Medicare health plan.
Strong knowledge of managed care concepts, provider contracting, and healthcare delivery systems.
Experience with provider rosters, credentialing, and regulatory compliance.
Experience with provider rosters, credentialing, and regulatory compliance (CMS, NCQA).
Proficiency with Microsoft Office Suite; ability to analyze data and prepare presentations.

Responsibilities

Build and maintain strong relationships with IPAs and hospitals.
Coordinate onboarding for new IPAs and providers.
Resolve provider inquiries in collaboration with internal teams.
Monitor network adequacy and provider satisfaction.
Organize quarterly meetings with IPAs and hospitals.
Internal Liaison – collaborate with claims, UM, credentialing, compliance, IT and finance to enforce terms.
Provider Events & Education – plan provider meetings, trainings, and appreciation events.
Network Adequacy Monitoring – review reports and develop action plans for access gaps.
Reporting – develop frameworks to track progress and network performance.
Growth and Development – identify opportunities, retention strategies, and outreach results.
Provider Adds/Terms – manage additions/terminations with credentialing and contracting teams.
Credentialing Support – facilitate credentialing applications and ensure NCQA/CMS adherence.

Skills

Relationship Building

Communication Skills

Problem-Solving

Organizational Agility

Attention to Detail

Project Management

Customer Service Orientation

Education

Bachelor’s degree in healthcare administration, business, or related field

Tools

Microsoft Office Suite (Excel, PowerPoint, Word)

PowerPoint

Word

Job description

Provider Relations Manager

Join to apply for the Provider Relations Manager role at Verda Healthcare.

Verda Health Plan of Texas has a contract with CMS and a state license with the Texas Department of Insurance for a Medicare Advantage Prescription Drug plan. We are committed to the idea that healthcare should be easily and equitably accessed by all. Our mission is to ensure that underserved communities have access to health and wellness services, and receive the support needed to live a healthy life that is free of worry and full of joy. We are looking for a Provider Relations Manager to join our growing company with many internal opportunities.

Are you ready to join a company that is changing the face of health care across the nation? Verda Healthcare, Inc. is looking for people like you who value excellence, integrity, care and innovation. As an employee, you’ll join a team dedicated to improving the lives of our Medicare members. Our vision incorporates value‑based health care that works. We value diversity.

Position Overview

The Provider Relations Manager at Verda Healthcare plays a key role in building, maintaining, and enhancing strong relationships with Independent Physician Associations (IPAs), hospitals, and other contracted provider groups. This position serves as the provider‑facing contact responsible for delivering high‑quality service and support to Verda’s contracted provider network, ensuring providers are supported through effective communication, onboarding, issue resolution, and performance monitoring that enhance the provider and patient experience. You will execute network strategies, driving initiatives, reporting progress to leadership. This role will serve as a key liaison between provider partners and internal Verda departments, driving collaboration to meet regulatory, operational, and strategic objectives, while advancing network adequacy and ensuring a high level of provider satisfaction.

This position reports to the Senior Director of Provider Network as part of Verda Healthcare, Inc.

Responsibilities

IPA & Hospital Relationship Management – Serve as primary relationship owner for assigned IPAs and hospital systems; conduct regular check‑ins and ensure contract compliance and performance.
Provider Onboarding & Communications – Coordinate onboarding for new IPAs and providers; ensure timely delivery of materials, orientation sessions, and operational readiness.
Provider Inquiries & Support – Serve as point of escalation for provider inquiries, resolving issues in collaboration with claims, utilization management, credentialing, and other internal teams.
IPA Roster Management – Oversee roster submissions, validation, and updates; ensure timely and accurate provider data reporting to meet compliance and CMS requirements.
Joint Operations Committees – Organize and facilitate quarterly IPA/hospital Joint Operations Committee meetings; driving consensus on performance priorities and follow‑up actions.
Internal Liaison – Collaborate with internal stakeholders (claims, UM, credentialing, compliance, member services, IT, and finance) to enforce contract terms and regulatory requirements, including but not limited to resolve provider issues and streamline processes. Provide high‑level recommendations to enhance operational workflows and service delivery.
Provider Events & Education – Plan, coordinate, and host provider meetings, trainings, and appreciation events to strengthen partnerships and improve engagement.
Network Adequacy Monitoring – Review monthly IPA network adequacy reports. Work collaboratively with leadership to develop action plan for gaps in access and communicate network performance to IPAs, addressing network gaps and resolution.
Reporting – Develop and maintain reporting frameworks to track progress and strategic initiatives and network performance.
Growth and Development – Collaborate with Provider Network Operations leadership to identify growth opportunities, retention strategies, and outreach results.
Provider Adds/Terms – Manage and process provider additions and terminations, coordinating with credentialing, contracting, and directory maintenance teams.
Credentialing Support – Facilitate submission of provider credentialing applications, work with delegated Credentialing Verification Organization (CVO), and ensure adherence to NCQA/CMS standards.

Requirements

Minimum Qualifications

Bachelor’s degree in healthcare administration, business, or related field (or equivalent experience).
3–5 years of experience in provider relations, network management, or healthcare operations with a Medicare health plan, IPA, or hospital system.
Strong knowledge of managed care concepts, provider contracting, Medicare/MAPD, and healthcare delivery systems.
Experience with provider rosters, credentialing, and regulatory compliance (CMS, NCQA).
Proficiency with Microsoft Office Suite (Excel, PowerPoint, Word); ability to analyze data and prepare presentations.

Professional Competencies

Relationship Building: Ability to develop and maintain trusted partnerships with IPAs, hospitals, and provider groups.
Communication Skills: Strong written and verbal communication, including presenting to large groups and facilitating meetings.
Problem‑Solving: Skilled at identifying issues, analyzing root causes, and collaborating on timely resolutions.
Organizational Agility: Able to navigate cross‑functional teams and balance provider needs with organizational priorities.
Attention to Detail: Ensures accuracy in roster management, reporting, and compliance‑driven processes.
Project Management: Capable of planning, coordinating, and executing multiple provider initiatives simultaneously.
Customer Service Orientation: Committed to improving provider experience while supporting organizational objectives.

Verda cares deeply about the future, growth, and well‑being of its employees. Join our team today!

Benefits