Provider Relations & Network Development Specialist

American Health Plans; Fort Worth (TX); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Affordable Medical/Dental/Vision

Generous paid time-off and holidays

TeleDoc 24/7/365 access to doctors

Optional short- and long-term/disabilt

Employee Assistance Plan (EAP)

401K retirement accounts

Employee Referral Bonus Program

Job summary

American Health Plans in Fort Worth, TX seeks a Market Contracting Analyst to support provider contracts and CMS adequacy across current service areas. You will educate providers, maintain relationships, and report market changes to Health Plan leadership.

The role emphasizes collaboration with providers and vendors, ensuring credentialing compliance, and contributing to process improvements while traveling to network locations as needed.

Qualifications

• Experience in the health care field required.
• Prior experience in network development / network services preferred.
• Bachelor’s degree or 3 years of managed care experience required.

Responsibilities

• Contracting providers and essential vendors to maintain CMS adequacy.
• Ensure providers meet credentialing requirements for service lines.
• Educate providers on Health Plan functions and roles.
• Provide ongoing CMS and Health Plan policy updates.

Skills

Provider payment methodologies

Provider credentialing

Provider relations

Negotiation

Communication with medical staff

Team collaboration

Independent work

Education

Bachelor’s degree in Healthcare Administration or related field OR 3 years of managed care network development experience

Job description

American Health Plans in Fort Worth, TX seeks a Market Contracting Analyst to support provider contracts and CMS adequacy across current service areas. You will educate providers, maintain relationships, and report market changes to Health Plan leadership.

The role emphasizes collaboration with providers and vendors, ensuring credentialing compliance, and contributing to process improvements while traveling to network locations as needed.