Provider Relations & Network Development Lead

Parkland Health; Dallas (TX); On-site; USD 65,000 - 100,000; Full time

Job summary

Parkland Health is hiring a Provider Relations Representative to serve as the primary liaison between providers and the health plan, expanding the network including Behavioral Health and Physical Health. You will support a quality, cost-efficient network and collaborate across departments to improve care and patient experience.

The role emphasizes communication, provider onboarding, education, and program compliance with Parkland Community Health Plan policies and value-based care initiatives.

Qualifications

• High school diploma or equivalent required.
• Bachelor's degree in healthcare related field preferred.
• 5 years of provider support, education, negotiations, relationship management or contracting experience is required.
• 1 year of behavioral health experience required.
• 1 year of Texas Medicaid experience preferred.

Responsibilities

• Performs research and resolution of claims processing workflow and quality improvement process and provider reimbursement issues.
• Uses analytic tools to track health risks and compliance, as well as supporting the contract negotiation process.
• Executes provider recruitment to ensure network adequacy and resolves network access gaps.
• Executes on-boarding, education, and outreach activities to ensure provider adoption, adherence, and compliance with Parkland Community Health Plan (PCHP) quality management and accountable value-based care program.
• Performs provider on-boarding and orientation, including the development of related presentation materials,
• Conducts organized meetings with assigned providers and develops all supportive materials including meeting minutes, action plans, memoranda, etc.
• Supports and collaborates with all PCHP functional areas. Works on complex system-wide initiatives and acts as project lead.

Skills

Contract prep

Provider reimbursement

Financial acumen

Network development

Negotiation

Consensus building

Communication

Conflict resolution

Interpersonal skills

Time management

Detail orientation

MS Office

Education

High school diploma

Bachelor's degree in healthcare

Tools

Microsoft Office

Job description

Parkland Health is hiring a Provider Relations Representative to serve as the primary liaison between providers and the health plan, expanding the network including Behavioral Health and Physical Health. You will support a quality, cost-efficient network and collaborate across departments to improve care and patient experience.

The role emphasizes communication, provider onboarding, education, and program compliance with Parkland Community Health Plan policies and value-based care initiatives.