Provider Relations & Network Development Specialist

American Health Partners; Goshen (IN); On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Paid time off

TeleDoc access

Disability plans — short & long-term

Employee Assistance Plan (EAP)

401K retirement

Referral bonus

Job summary

American Health Plans, a division of American Health Partners Inc., is seeking a skilled professional to contract providers, manage credentialing, and educate network physicians under CMS guidelines. This role supports network operations and requires travel to provider sites.

Strong communication and negotiation skills, plus the ability to work independently and in teams, are essential for success and ensuring compliant, high-quality member care.

Qualifications

• Knowledge of medical services at all levels and the ability to rapidly build working relationships.
• Ability to take directions and work independently to complete goals and assignments.
• Strong negotiation, organization, presentation and time-management skills.
• Effective communication with all levels of medical staff to explain plans, benefits, and goals.
• Ability to work well in a team environment.
• Proficient computer skills including Microsoft Office.

Responsibilities

• Contract providers and essential vendors in current service areas to maintain CMS adequacy and services for Plan members.
• Ensure providers meet credentialing requirements for their service lines.
• Educate providers on Health Plan functions and roles.
• Provide ongoing CMS-mandated educational updates.
• Conduct education presentations to ensure provider understanding and engagement.
• Maintain provider relationships to ensure network coverage in all areas.
• Collaborate on implementation and drive process improvements.
• Complete corporate assignments as needed.

Skills

Medical services knowledge

Independent work

Negotiation

Communication

Team-oriented

Microsoft Office

Education

Bachelor's degree

Tools

Microsoft Office Suite

Job description

American Health Plans, a division of American Health Partners Inc., is seeking a skilled professional to contract providers, manage credentialing, and educate network physicians under CMS guidelines. This role supports network operations and requires travel to provider sites.

Strong communication and negotiation skills, plus the ability to work independently and in teams, are essential for success and ensuring compliant, high-quality member care.